Jessieca Leo - Sex in The Yellow Emperors Basic Questions - Sex, Longevity, and Medicine in Early China

Praise for Sex in the Yellow Emperors Basic Questions
Thisbookisfascinating,deep,essentialreadingforanyoneinterestedin
sexasthehiddenforcerulingbodilyandspiritualhealth.AdeptsofDao
istsexology,OrientalandWesterndoctors,sextherapists,psychologists,
energy workers,as well asscholars, archeologists,poets, andhistorians
ofChinesecultureorsimplycuriouslayreadersallwillfeeltheyhave
beeneroticallyandpsychosexuallysated.
Human culture here is a vast jigsaw puzzle, with sex as the key
piece linking cosmology, empirical and magical medicine, the popular
culture of love, its diseases and its euphoric desires, Confucian family
dynamics, bisexual emperors, eunuchs, longevity qigong, and Daoist
philosophy.
I have been reading works in this field for thirty years and was
amazed at how much new Jessieca Leo had to teach me. Who would
guessthatConfuciuswassiredduringanorgiasticSpringFertilityRite?
Herpenetratingresearchdeftlyilluminatesandvivifiestheofteninscru
table Yellow Emperor and Mawangdui manuscripts of 2200 years ago.
Thisisabookyouwillliterallytaketobed.
MichaelWinn,HealingTaoUSA
Jessieca Leo examines a part of the Chinese classical medical tradition
that has until now received little attention. The authors broad scholar
ship and familiarity with the tradition and thetext allow her to explore
social and historical themes while examining philological and medical
issues. This book deserves a place on the shelves of all scholars of the
ancient Chinese medical traditions. It is also essential reading for mod
ernscholarsandpractitionerswhoarepartoftheneoclassicalrevitaliza
tionofTraditionalChineseMedicine.
StephenJackowicz, AdelphiUniversity
InherworkaboutsexandlongevityintheHuangdineijing,JessiecaLeo
presents an excellent and detailed study of the earliest systematic
thought about the physical, physiological, psychological, and environ
mentalaspectsofsexualityandhowtheyarerelatedtolongevity.
Thiscomprehensivevolumeisasuperbintroductiontothemedical
theoryofsexuality,beginningwiththedifferenttermsusedinspeaking
aboutsexualinteraction,theanatomyandenergetics,uptoreproductive
physiology and pathology. Based on her own new translation of the
relevantpassages in theSuwen,the author offers anew anddeeper un
derstandingoftheearliestfundamentalsofsexualitynotonlyintermsof
Chinese Medicine, but also how sexual cultivation and health care are
practicedwithinbedchamberartsandlongevitytechniques.Ihighlyrec
ommend ittoeveryoneinterestedinthesexualcultureofChina.
DominiqueHertzer,University ofMunich
JessiecaLeohasopenedoureyestoafascinatingaspectofearlyChinese
thoughtthatWesternersseldomhaveaccessto.UsingChinesemedicine
asthebackground,shetracesthedevelopingunderstandingofsexuality,
andthepartitplaysinlifeandsociety,whiletheanalysisalwaysreturns
to the balancing nature of Chinese philosophy. Much is surprisingly
relevanttotoday,fromthepursuitofpleasuretothewarningsofmixing
sex and alcohol. Anyone interested in Chinese history and culture will
findit hugelyenlightening.
RichardBannerman,BBC
Jessieca Leo traces sex and sexuality in early China insourcesthathave
long been neglected. Clear language and new translations from
the YellowEmperorsBasicQuestionsguidereadersonaninterestingtrack
into abasic aspect of Chinesehistory andculture. The book is an abso
lutemustforanyoneinterestedintraditionalChinaandthehistoryand
cultureofhumansexuality.
RodoPfister,University of Basel
JessiecaLeos SexintheYellowEmperorsBasicQuestionsisatrulyremark
ableachievement.Leosuccessfullycombinesphilologicalprecisionwith
fresh analyses, questioning the received communis opinio on sexuality,
medicine, and sexual culture in early China. It is easy to read and a
pleasuretodigest.Highlyrecommended.
BurkhardScherer,ChristChurchUniversity
Sex
in the
Yellow Emperors
Basic Questions
Sex, Longevity, and Medicine
in Early China
Jessieca Leo
Three Pines Press
ThreePinesPress
P.O.Box609
Dunedin,FL34697
www.threepinespress.com
2011 byJessiecaLeo
Allrightsreserved.Nopartofthisbookmaybe
reproducedinanyformorbyanymeans,electronicor
mechanical,includingphotocopying,recording,orbyany
informationstorageandretrievalsystem,withoutpermission
inwritingfromthepublisher.
9
87654321
FirstEdition,2011
PrintedintheUnitedStatesofAmerica
Thiseditionisprintedonacidfreepaperthatmeets
theAmericanNationalStandardInstituteZ39.48Standard.
DistributedintheUnitedStatesbyThreePinesPress.
Coverart: Paintingby OlgaMariePolunin
(http://www.biotechnics.org/2olgamariepolunin.html)
LibraryofCongressCataloginginPublicationData
Leo,Jessieca,1953
SexintheYellowEmperorsbasicquestions:sex,longevity,andmedi
cineinearlyChina/JessiecaLeo. 1sted.
p.cm.
Includesbibliographicalreferencesandindex.
ISBN9781931483186(alk.paper)
1. Gongsun,Long,3rdcent.B.C.2. SexChinaHistory.3. Sexual
healthChinaHistory.4. LongevityChinaHistory.5. Medicine,Chi
nese. I.Title.
HQ18.C6L462011
306.7095109014dc22
2010050527
For Thomas
Contents
Foreword
Acknowledgments
Preface
1.StudyingSexinChineseCulture
ix
xiii
xiv
1
2.TheYellowEmperorsText
22
3.TheLongevityConnection
37
4.PathologicalDiagnostics
52
5. SpeakingofSex
67
6.ExpressionsofSexualInteraction
79
7.SexualEnergetics
92
8.SexualAnatomy
115
9.ReproductivePhysiology
135
10.Overindulgence andIntoxication
151
11.SexandHealth
165
12. Sexinthe Suwen
177
Translations
Bibliography
Index
181
191
211
List of Illustrations
Fig.1:a)Position19intheSue pian:Thesunandmoonunitetheir
jade disks.b) Position 35: Jade mountain stands alone. Pencildraw
ings.SiahTiongHong,2010(www.konospoon.net).Usedbypermis
sion.
Fig.2:PrinceLiuShengsdoublephalliwithovalstones.Unearthed
inMancheng,Hebei;ca.113BCE.DrawingbySiahTiongHong.Usedby
permission.
Fig.3:a) Peniscradles; b)Bronze dildos;c) theircombineduse.
LaterHan;fromsuburbofXian,Shaanxi. Courtesyof Kaoguyuwenwu.
Usedbypermission.
Fig.4: Shortshovelwithphallichandle.FromDianculture,Yunnan.
LaterHan. Pencil drawingbySiahTiongHong.Usedbypermission.
Fig.5: a) Kissing couple.Stonerelief. LaterHan;fromLeshan,Si
chuan. b) Intimatecouple. Stonerelief. LaterHan;fromPengshan
County,Sichuan. c)Kissingcouple underarches. Stonerelief.LaterHan;
RongjingCounty,Sichuan; d) Intimatecoupleinsocialsetting. Rubbing
ofpotterytombrelief.LaterHan; FayangCounty,Sichuan. Courtesyof
ChineseCulturalFoundationofSanFrancisco. Usedbypermission.
Fig.6: GaoMei illustratedbricks.LaterHan; XinduCounty,Sichuan.
Pencil drawingbySiahTiongHong.Usedbypermission.
Fig. 7: The cycles of the five phases. Courtesy of Shawn Arthur.
Usedbypermission.
Fig. 8: Position 26 in the Sue pian: Couching tiger and curling
dragon.Pencil drawingbySiahTiongHong.Usedbypermission.
Fig. 9: Position 31 in the Sue pian: Reverse piercing of the hibis
cus. Pencil drawingbySiahTiongHong.Usedbypermission.
Fig. 10: Yangsheng fang drawing of the vagina. From Mawangdui,
Hunan;before 168BCE.Drawing.IrisHuck.Usedbypermission.
Fig.11:NWaandFuXi.LaterHan; ChongqingMunicipality.Pen
cil drawingbySiahTiongHong.Usedbypermission.
Fig. 12: Position 32 in the Sue pian: Turning earth and reverting
heaven. Pencil drawingbySiahTiongHong.Usedbypermission.
Foreword
UnlikemanystudiesofChinesesexualculturethathavetendedtofocus
onChinese erotic literature, Jessieca Leos work examinesmedicaltexts
to find information on human sexual culture. Her study opens com
pletely newvistas:her approachnotonlyallowsreaderstobecomemore
familiarwiththequestionofhowsexualityisunderstoodfromthepoint
ofviewoftraditionalChineseanthropology,italsoleadstoadiscussion
ofsexualityinthewiderperspectiveofhumanhealthandlife.
The text at the basis of this study is the Suwen (Basic Questions)
whichbelongstoabodyoftextsdedicatedtotheYellowEmperorthe
mythical progenitor of ancient Chinese civilization. Issues of the origin
andtransmissionofthisbodyoftextsarecomplicated:thebooksinclude
the accumulation, amendment, and reshaping of scripts, together with
annotations by various medical schools covering well over 500 years.
Despite thesevariations in form andcontent, the Suwenbecame theca
nonicaltextformedicalreasoningandshaped medical tradition.
Rather than focusing on diagnostics and therapy of distinct dis
eases, Jessieca Leo discusses questions regarding the effective function
ingofthehumanbodyandpossibledisturbances.Herpresentationpro
videsinsightsonhowhumanactionandbehaviorareconceptualizedin
earlyChinesethinking.TheSuwen,sheconvincinglyshows,exposesthe
deep concern of the ancient Chinese for prolificacy and fertility in the
serviceof securing a greaternumberof offspringtocontinue the ances
tral line. Rich in content, the work presents an impressive array of an
cientChinasknowledgeabouttheinnerfunctionsofthehumanbody.
Although core layers of the Suwenmay go back to the 1st century
BCE,itscontentshowsaratherelaborateconceptualframeworkdefined
bytheinteractionofyinandyangaswellastheflowandmovementof
energetic constellations (qi) along fixed circulatory systems or vessels
(mai). Thisshowsatraditionofmedicalthinkingthatfocusesonpreserv
ingagreatanddeep bodyof knowledgeabout the humanbody.
However,strikingasitis,thisdetailedframeworkofmedicalthink
ingisnotdetachedfromamorebasicoutlookonnatureandhumanso
ciety.Chinesemedicallanguage,althoughhighlyspecializedandrather
technical, is not separate from a broader understanding of nature and
ix
x / Foreword
society. Instead, medical thinking of human functions parallels beliefs
and observations of cosmological actions, natural phenomena, and hu
manorganization.
As the author shows, from theirlinguistic expression,parallelcon
ceptsbelongingtodifferentlevelsof discourse canbedescribedasakind
ofmetaphoricalextensionofmeaning.Forinstance,physicalcirculatory
systemsarecalledmai,thusmatchinglandscapeformationsofriverval
leys and mountain ranges; physical parts and functions are said to be
longto yin or yang, whichdenote a greatrangeofnaturalphenomena.
On a deeper conceptual level, however, the correspondence of the hu
manbodytotheformsandstructuresofnaturerestsinthestrictlyfunc
tional view of human and natural actions by stressing the interplay of
complementarypowers. Thereby,thetext showsthe strongnatural ten
dency tobalancepowersandmaintainregularityandresilience.
Earlier,nonmedical literatureprovidessome evidencethathuman
sexuality and reproduction were understood in terms of cosmic action.
From this we can trace the ideological background of the Suwen. As
StephenOwenpointsoutinhisReproductionintheShijing(Classicof
Poetry)(HJAS2001),ancestralhymnsconceptualizehumanfertility and
reproduction alongside the cultivation of land, growth, and production
of seeds and food supplies. Regularity of the seasons and the cycle of
sowingandharvestingmatchthe continuityoftheancestrallinethrough
succeeding generations. Early Chinese rulers were held in esteem re
garding their knowledge of how to participate in the natural cycles of
nature,bringing fecundity to the fields, andprotecting their fruitsfrom
harm. Rituals and sacrifices were conceived as a means to secure the
progeny of theclanandtheresourcesofthepeople.
That is to say, reproduction does not only require a profound
knowledgeoftheoperationsofheavenandearthbutalsoanexpertisein
helpful methods. The wellknown definition, according to the Chinese
tradition,ofthehumanbeingaspartofnaturemeansthat,bymeansof
intelligence, humanity is capable of cooperating with the productive
cycleofheavenandearth.
Consequently, sexuality and the knowledge of the methods of re
productionshouldbeseenintheirlifesustainingfunction.InearlyChi
nese anthropological thinking, ethical norms and regulations of social
behaviorareexpressedinthestrictseparationofsexesduringsocialin
tercourse.Thetraditionofseparationofsexesisnotconceivedasamove
Foreword / xi
awayfromsexuality,ratherasmeanstocontrolandguidehumansexual
behavior in certain ways believed to be consistent with the dualistic
schemeofnature.
The belief, moreover, that the individuals body is inherited from,
andgivenby,theancestors,asJessiecaLeoemphasizes,iscrucialforthe
understandingofsometraditionalideasofsexuality.Forinstance,pres
ervationofthebodyanditsphysicalfunctionsshowsrespectforthe par
ents.Ampleoffspringmanifest theclansstrengthand itsgood fortune:
itisatributetothisdonation.PassagesintheSuwen,speakingoffecun
dationandgestation,demonstratethebeliefintheancestralbestowingof
the faculties of fecundation and conception on individuals. As a social
consequenceofthisbelief,theChinesemakesureofthepartnersfamily
descent before marriage. In addition, their belief in the inheritance of
sexual capacity from the ancestors contributes to the understanding of
the equation of sexual potency and child bearing capacity with human
life preserving forces. Preservation of the body thus also means taking
care of the functional abilities of the genitals, using exercises, dietetics,
and abstinencefromanyexcessiveandunrestrainedbehavior.
Jessieca Leo presents a meticulous study of the language of sex in
the Suwen. She identifies different layers of sexual language, finding
some that matches earlier medical texts and health care manuscripts
usedinthelatermedicaltradition.However,sincesexualityisnotawell
defined issue in the early Chinese medical texts, her work functions
hermeneutically as a key to understanding and interpreting concepts
thatbringsvariouspropositionsonbodilyfunctionstogether.
Sexual language in the Suwen comes in many linguistic forms.
Jessieca Leo presents expressions of a common language denoting re
production or human genital instruments, as well as common expres
sions like ru or nei, entering or going inward, used in the special
sensedescribingphases ortypesofsexual intercourse.Expressions of a
more refined metaphorical language like jade stalk, denoting the pe
nis,standsideby side with an established vocabulary inmedicinal dis
courselike vessels,as partofa moresystematic medicalterminology.
Finally,thetechnicallanguageofnonmedicaldiscoursesdescribing
complexinteractionsofvariousentities,actionsorqualities,forexample,
intherealmsofsocialgovernmentorcosmicoperation,becomessexual
ized by transposing it into the context of the reproductive organs. The
organizationofthemedicalmaterialinthisbookalongvariousaspectsof
xii / Foreword
human sexuality shows a great and fascinatingpicture of early Chinese
sexual thought which is seldom treated elsewhere. Comments on the
cultural background as well as on the Chinese medical and health care
tradition enrich the presentation and exhibit their points of difference
andcontinuity.Annotations relating tomodernbiomedical knowledge
help the understanding of thematter andbuild abridge overtime and
cultures.
DennisSchilling,LudwigMaximiliansUniversity, Munich
Acknowledgments
IwishtothankDennisSchillingforhisguidanceandpatiencewhenever
I throw some crazy ideas at him. No less deserving thanks go to Rodo
Pfister for putting me on the right track whenever I veered too far off.
However,anyerrorsinthebookaremineandminealone.Specialthanks
also go Etain Addey, Richard Bannerman, Dave Campbell, Ute Engel
hardt, Irmgard Enzinger, Peter Gensmantel, Goh Eck Kheng, Marta
Hanson, Dominique Hertzer, Thomas Hoellmann, Shihshan Susan
Huang, Iris Huck, Louis Joseph, Lena KennerknechtHirth, Angie Lee,
Ulrike Middendorf, Maria Schreibweis, Siah Tiong Hong, Harcharan
Singh,Herman Tessenow, as well as readers for Three Pines Press for
their generous contributions one way or another; and last but very im
portantly,thepersonwhomadethispublicationareality LiviaKohn.
xiii
Preface
Why sex and sexuality in the Huangdi neijing suwen (The
Yellow EmperorsInner Classic:BasicQuestions)?When Ifirstread the
beginningofthe text,Iwasfascinatedbyjusthowmuchknowledgethe
early Chinese had of sex and sexuality in the realm of reproductive
physiology and health care principles. The Suwen is the oldest Chinese
medicaltextbook,compiledbetweenthe1st centuriesBCEandCE,butit
includes materials from as early as the 4th century BCE. Already over
2000 years ago the Chinese were working with such complicated and
abstract physical, physiological, psychological, and environmental con
ceptswithinwelldefinedandsystematized medicaltheories.
Inthisstudy,IshowthattheSuwenrepresentsastageinthedevel
opmentofmedicaltheorieswheretheybecameempirical,i.e.,physicians
diagnosed and treated diseases by using appropriate techniques and
healingprocessesthey observed andrecorded. I achieve thisby tracing
howMawangdui teachingsofyangsheng ,the arts ofnourishing life
orlongevitytechniques,influencedthedevelopmentofvesseltheoriesin
theSuwen. Sexualcultivation or thebedchamber artsformed an impor
tantbranchofyangshengteachings;theywereabridgeforthecrossover
from spiritbased magical medicine into welldefined and systematized
theories.
The medical texts from Mawangdui indicate that sex was an inte
gral part of health, longevity, and medicine. To set the study in a dia
chronic dimension, I compare the Suwen with the Mawangdui corpus
andvariousmaterials from preHanandHan literature;and Ialsopre
sentthelatestarchaeologicalfindingsoferoticobjectsfromtheHanpe
riod. They all reveal sexual culture in different historical, intellectual,
andsocialcontexts.Thesynchronicdimensionofthisstudy,ontheother
hand, is represented by an evaluation of the materials pertaining to
sexuality in other medical works, notably the Maijing (Classic on
Vessels), Nanjing (Classic of Difficult Issues), and especially the
Lingshu (Spiritual Pivot) because of its historical connection to the
Suwen.
By lookingathowtheSuwendepictssexinassociationwithmedical
theories, Ihopetocomecloser to understandinghowthe early Chinese
xiv
Preface / xv
viewed sexuality. Itseems appropriatetostart withthe Suwennot only
becauseitistheearliestChinesemedicaltextbutbecauseitiscentralto
Chinesemedicine bothtraditionally andtoday.Almostevery postSuwen
medicaltextquotessomethingfromitandforanystudentembarkingon
thestudyofChineseMedicinetoday,theywouldhaveheardoftheSu
weninoneformoranotherfromtextbooksthatmakeselectivereferences
toSuwens theories.
SincethisstudyattemptstoshowhowtheSuwenportrayssexuality
intherealmofmedicalknowledgewithreferencetothesocialandliter
ary context ofthe Hanperiod,a large part ofthebook is given overto
thesemanticsofdescribingthesexualact,sexualanatomy,andthepro
creationprocess.Theworktraceshow thenotion of sex is expressed in
earlywritingsandthesemanticsofsexualityintheSuwen.Itdealswith
health care pertaining to sex, sexual maladies such as erectile dysfunc
tion,andtheconsequencesofoverindulgenceinsex,food,andalcohol.
Itoutlinestraditionalvisionsofthereproductiveprocess,includingcon
ceptsofsexualmaturity,conception,fertility,anddeclineasdepictedin
theSuwen.Finally,itlooksatsexandhealthwithinSuwenmedicaltheo
riesaspartoftheemergingmedicalfaculty.
Chapter 1hasthreeparts thatpresent an overview of the research
andstudyofsexualcultureinancientandearlyChina.First,Ireviewthe
currentstateofresearchonChinesesexualculture.NextIshowthevari
ous categories of early literature that reveal sexual culture in different
historical, intellectual and social contexts. They include historical docu
ments,medicaltexts,courtliterature,andsexualmanuals.Inthelastpart,
IpresentarchaeologicalfindsoferoticobjectsfromtheHanthatdivulge
moreinformationonsexualculture.
Afterthis,Chapter2setsouttopresentthehistoryofSuwenstudies
andthemethodologyusedinthisstudy.Italsopresentsthetextualhis
toryoftheSuwen,itscompilationprocess,andthewaysinwhichWang
Bingcreated hiscopy,themaineditionofthetext.
Chapters3and4exploretheconnectionbetweentheSuwenandthe
various longevity techniques in sex, health, and medicine. It looks at
how Wang Bing connects yangsheng doctrines to medical theories and
howheusesthemtobridgespiritbased magicalmedicinewithsystema
tized and empirical medicine. This part of the work examine whether
sexualcultivationas abranchofyangshenghasanythingincommonwith
Daoistculture.Itcompares thedevelopmentofprotomedicaltheoriesas
xvi / Preface
seen in Mawangdui medical texts to those that are systematized in the
Suwen.Thediscussionsofthedifferentpathologicalfactorsanddifferent
healthprofessionalsshowhowtheSuwenformulates,develops,andsys
tematizesmedicaltheories.Chapter4inparticularexaminestherolesof
diagnostics mentioned in the Suwen and how they contributed to the
healingmethodsthatdemonstratethedevelopmentofmedicalthoughts.
Chapters 5 and 6 examine the language used in speaking about
sexuality. They focus on how sex is conducted and how sexual inter
courseisdescribed.Chapter5beginsbydiscussinghowpreSuwentexts
andtheSuwenexpressdesire.Thisisfollowedbyhowancientandearly
writersscholarscommunicatethesexualacttoitsreadersusingimagery,
euphemismordirectreferences.Itexaminesthesexualactatitsvarious
stages using materials mostly culled from the Mawangdui manuals.
Chapter6,incloseconjunctionwiththis,conveysthedifferentterminol
ogiesusedtodescribesexualinteractionintheSuwen.Itshowsthatnot
onlysexualvocabularywascodifiedbutithaschangedbythetimethat
the Suwenwascompiled.
After establishing the role of the sexual act in the Suwen medical
theories, Chapter 7 explores sexual energetics such as thebinary power
of yin and yang. I discuss the roles that essence (jing), qi, the kidneys,
and the three extraordinary vessels (Conception, Governing, and Pene
trating) playinmedicaltheoriesrelatingtosexandsexuality.Theirfunc
tions in the dynamics of sexual physiology in TCM today are basically
stillthesameasthosepropagatedintheSuwen.
In Chapters 8 and 9, Ideal with sexualand reproductive anatomy,
thephysiologyofproducingprogeny,aswellaswithobstetricsandgy
necology and their relation to the medical theories of the Suwen. The
chapters also look at historical concepts such as the ancestral tendon
andheavenlystock.Bothconceptsarefundamentaltosexandsexual
ityinthe Suwen but donotappearinothermedical textsorliterature.
Chapter10 discussestheeffectsofoverindulgencesandintoxication.
The first part showshow sexual Dao is integrated intomedicaltheories
andhowadheringtoitsrulescanpreventdiseasesandachievelongevity.
The classic troll of healththe foolish act of having sex while intoxi
catedistheproverbialmalaiseoftheupperclassesanditisdiscussedin
thenexttwosections.Thecombinationofsexandalcoholwasandisstill
thescourgeofhealthandlongevity.
Preface / xvii
Chapter11 presentstheeffectsofsexonhealth.Itisconcernedwith
sexual excesses caused by lust and how human follies produce overin
dulgenceofsexualactivity,whichultimatelyaffectshealth.Thenextsec
tion studies sexual dysfunction in the form of erectile dysfunction and
other problems affecting the sexual act and sexual health. This chapter
endswithashortdiscussionontheuseofaphrodisiacintheMawangdui
texts and Suwen. Sexual health has clearly become part of the medical
equationof theSuwens medicaltheories.
Overall, the book shows that the Mawangdui medical texts repre
sentatransitional phaseinwhichmedicaltheorieswereunfolding,while
theSuwenpresentsmedicaltheoriesthatarealreadywelldevelopedand
systematized. I hope to showstudents and scholars a view of sexuality
withintheboundariesofthesesystematizedmedicaltheoriesthatrelates
to the causes and etiology of diseases as advocated in the Suwen, thus
givingsexaroleinmedicaltheoriesasformulatedintheHan.However,
given that Suwen studies have such a long history, I do not pretend to
passthisoffasanexhaustivework.Rather,Ihopeitistheopeningsalvo
for morefireworks tofollow.
JessiecaLeo, January2011
Chapter One
Studying Sex in Chinese Culture
The great desires of human beings are drink, food, and sex.
Liji
WebstersDictionarydefinessexas:1)oneofthetwodivisions,especially
inhumanbeings,designatedasmaleorfemale;2)thesphereofinterper
sonalbehavior,especiallybetweenmaleandfemale,mostdirectlyasso
ciatedwith,leadingupto,substitutingfor,orresultingfromgenitalun
ion. It defines sexuality as the quality or state of being sexual: a) the
condition of having sex; b) the condition of having reproductive func
tionsdictatedby the union ofmale and female;c)the expression ofthe
sexinstinctinsexualactivities;and, d)thecondition,potential,orstateof
readiness, of the organism with regard to sexual activity (1993, 2081).
Duetothedifferencesindefiningsexandsexuality,Ihavechosentouse
thetwoasasingleentityinthisstudy.
The problem with this and other modern definitions of sex is that
theyareoftenheteronormativeorbiomedicallyoriented,makingthem
incomplete, prejudiced, and limiting. Medical and heteronormative bi
nary constructionofgenderisa complexaffair.As SuzanneKesslernotes,
not only is sex assignment uncertain but the empirical foundations on
whichthemedicalorthodoxiesofbinarysexandgenderarebuilton,are
weak (1998, 1213). Both she and Alice Dreger (2000) point out that fe
male or male is neither natural or fundamental but rather constructed
and normative. Gender markers such as genitals, gonads, or chromo
somes are insufficient to make the distinction in some people. Humans
arebiologicallymorecomplex in terms of sexual variantssuch asinter
sexualsorhermaphroditesallthingsthatchallengethesimplisticmale
femalebinary.
Webstersdefinitionstendtoreducethesexualacttoaclinicalphysi
calconnectionbetween amale and a female, and sexuality to a state or
1
2 / Chapter One
condition in which the sexual act takes place. In such a definition, the
humanexperience,suchasdesireandpleasure,aswellasthesexualact
as the cause of diseases or euphoric states are disconnected from their
social and anthropological contexts. Emotions, control, responsibility,
nature,andlifestyleareleftoutoftheequation.
TheancientChinese saw sexfirst asameansof survivalandlateron
aspartoftheConfuciandutyofproducingmaleprogenytoperpetuate
theancestralline.Still,theyuseditforpleasureaswellasforenhancing
health,creatingspecifictechniquesofsexualcultivationadvocatedinthe
arts ofnourishing life knownas yangsheng .TheHuangdineijingsu
wen (TheYellowEmperorsInnerClassic:BasicQuestions),1
themainfocusofthisstudy,depictssexasanallencompassingconcept
including not only genderization of the sexes,but also the sum total of
thephysiological,psychological,andanatomicalfunctionsofthehuman
being. It explains sex as a series of structures, functions, activities, and
attitudescharacterizedbyanaturalandfundamentaldifferencebetween
female and male, which accompanies people throughout life from con
ceptiontodeath(Evans1997,34).
TheancientChinesesawwomenascosmologicallyequalandcom
plementary to men. 2 They explored sexual intercourse as contact be
tween heterosexual partners, and to them sexual cultivation stipulates
that yin (female) and yang (male) components complete the union. As
such,sexualencountersinearlymanualsandtheSuwenrepresentahet
eronormativeperspectiveembracingtheDaoofyinyang.
Previous Research
Thelate19th centurysawtheemergenceofaheightenedChineseinterest
in the study of sex and sexuality as an academic and scientific subject
withinawidersocialandculturalcontext.ThiswasledbyKangYouwei
TheSuweneditionusedhereisbyLinYi,GaoBaoheng,and
SunQi,foundinSibubeiyao(Shanghai:Shanghaizhonghuashuju,
1936).FortheHuangdineijingtaisubyYangShangshan(8th
c.),Iuse:Beijing:ScientificandTechnicalDocumentsPublishingHouse,2000.
2 ForadetaileddiscussionofwomensroleinChinesecultureasdepictedin
literaturefrompreQintoHan,seeWangRR2003,1194.
1
Studying Sex in Chinese Culture / 3

(18581927) and Tan Sitong (18651898) in their seminal
works titled Datong shu (Book of Great Unity) and Renxue

(StudiesinHumanity).Althoughtheseworksarepolitical, theideas they
propagate inspired areform movement in which love, sex,and women
playedimportantroles.Themostnoteworthyworkofthaterathatcon
tributed to the resurgence of interest in Chinese bedchamber arts is Ye
Dehuis (18641927) Shuangmei yingan congshu (Col
lectionoftheShadowoftheTwinPlum),publishedin1903.
Using Chapter 28 of the Ishinp (Essential Medical Meth
ods)a text compiled in 10thcentury Japan on the basis of Chinese
documents(seeHsiaetal.1986)andothertextsonsexualcultivation,
YeDehuireconstructedsexualcultivationtextssuchasthe Sunjing
(Book ofthe PlainWoman), Xuannjing (Book of theMystery
Woman), Yufang mijue (Secrets of the Jade Chamber), and the
Dongxuanzi ([Way of] Master Dongxuan). In his preface, he la
mentsthat,whiletheWesthasathoroughknowledgeofsexandsexual
hygiene andpossessessomanybooks on the subjectthat even an igno
rantfellowcanbecomeanexpert,itsscientistshavenoideathatthede
scendantsofChinasholyemperorsalreadydevelopedbedchamberarts
4,000 yearsago.
Interest in the bedchamber arts in other areas of study further en
hanced the understanding of Chinese sexual culture by providing new
perspectives.Forexample,newwaysofinterpretingtheclassics,suchas
the Shijing (Bookof Poetry) and Chuci (Songs ofChu)by Chi
neseandWesternscholars,addedtotherisinginterestinsex.3
The Shijing, the oldest collection of 305 Chinese poems and songs,
datedtothe6th centuryBCE,becamethefocalpointofmanystudies.In
1927,WenYiduo (18991946)inhis Shijingdexingyugan
(TheNotionofSexualityintheShijing)showedthateroticismexisted
inmorethanfortypoemsbyexaminingthevarioustropesascarriersof
sexualcontentusingasetoffivefiguresofspeech,ordevicesthatcon
veyedsexualintercourse (Middendorf2004,21415).
VanGulikhastranslatednolessthantwelvepoems,whichhecon
sideredtohavesexualconnotations(#189,21,158,22,95,93,99,81,58,
3 For revival of interest in the Shijing, see also Middendorf 2007; 2004;
Goldin 2002, 447; Harbsmeier 1995, 32346; Riegel 1997; Bischoff 1985, 4; Van
Gulik1961,1625.
4 / Chapter One
102, 76, and 264). Bischoff states that members of the Orchid Tower
(Lanting )heldallmaleorgies,duringwhichtheyinterpretedpoems
from theShijinglegitimately and illegitimately. Byillegitimately he
means erotically and sexually (1985, 2930). They practiced a form of
phallicworship: men,oldandyoung,mettoharmonizeqi.Thiswas
still en vogue in the mid4th century CE, as the Songs of the Orchid
Tower oftheyear353indicate(Bischoff1985,4).
Correspondingtothesexualrevolutionofthe1960s80sintheWest,
a wave of popular Chinese ars erotica appeared in the Western market
that emphasized the stereotypes of oriental sexualism. In depicting the
Chineseasquaint,pleasureseekingfolkswithunusualsexualhabitsand
infavorofcuriouspractices, theyreinforcedVanGuliksviewthatsexin
China was natural and unproblematic (Schipper 1993, 146). Nothing
couldbefurtherfromthetruth:Chinesesexualcultureisacomplexphe
nomenonintimatelylinkedtophilosophy,medicine,healthcare,religion,
eugenics,andfamilylife.
Many popular works on Chinese sex had attentiongrabbing
teasertitles and werepublishedmostly for theircommercialvalue as
exotic orientalism. They show pictures of copulating couples in un
usual positions and sometimes with circuslike antics. Most of these
paintingswerefromtheMingandQingperiods,whichmeantthatthey
represented only a small part of the history of Chinese sexual culture.
Someofthesepublicationsareinterestingbutoveralltheyarenothelp
fulforresearchbecausetheyhavelittlebibliographyanddonotdiscuss
historical context. As a result, these attempts at tackling this many
faceted topic produced books that wet the appetite but they also per
petuated the stereotype erotic image of Chinese sex culture. The only
exceptionisVanGuliksseminalwork,SexualLifeinAncientChina,writ
tenbeforetheMawangduimanuscriptswere found and now subjectto
certaincontroversies(seeFurth1994; LiL.1992).
BeforetheMawangduimanuscriptswerediscoveredin1973,onlya
handful of Chinese, Japanese, andEuropean scholarswere interested in
Chinese sexual culture. Leaders in the field includeWesternerssuch as
Henri Maspero (18821945), Joseph Needham (19001995), Robert van
Gulik(19101967),andHerbertFranke(1914 ).Theirfocuswasonsexual
classicsmostlyfromtheSuiandTang dynasties onward.

It was not until the 1990s that a flourish of scholarly works ap
peared,both inChinaandtheWest.4 Theyimprovedthefieldandgave
thestudyofsexmorescope.Also,itseemsthatthetermfangzhongshu
(bedchamber arts) acquired new currency among the Chinese
judging by the number of books offering bedchamber secrets on the
market in the 1990s. However, even in the 21st century and despite the
revivalofinterestinChinesesexualculture,bothacademicandpopular,
aheadlineintheNewYorkTimessumsuptheoverallsituationforthose
whoembarkonthisjourney:LongAfterKinsey,OnlytheBraveStudy
Sex (Carey2004).
The Mawangdui Manuscripts

Thesinglemostimportanteventthatrevivedinterestandgaveacademic
kudosandrespectabilitytothestudyofsexandsexualityinChinawas
thediscovery,in1973,ofthreesexualmanualsintheMawangduitomb
complexnearChangsha,Hunan.Thecomplexcontainsthreetombs.The
firsthousedtheMarchionessofDaiwhodiedataboutfiftyyearsofage.
Thesecond,asshowninthreeseals(twobronzeandonejade),belonged
toLiCang, MarquisofDaiand chancellorofthekingdomofChang
sha, who died in 186 BCE.The third wasoccupiedby one of LiCangs
sons,who diedatage thirty.Aburialtabletindicatesthatitwasclosedin
168BCE.
The manuscripts, stored in a rectangular lacquer box with a roof
shapedlid foundinthelatter,consistofthirty itemscontainingfortyfive
separatetexts ( pian).Seven items or fourteen textsaremedical inna
ture;abouthalfofthemdealwithnourishinglife,andamongthesethree
presentthebedchamberarts.5 They arethe Shiwen (Ten Questions),
Heyinyang (UnitingYinandYang),and Tianxiazhidaotan
(DiscourseoftheSupremeDaoUnderHeaven;hereafterabbreviated
4 Works by Western scholars include: Hinsch 1990; Kapac 1992; Liu 1993;
Diktter1995;Tsai1996;Liuetal.1997;Evans1997;Goldin2002;Farquhar2002;
Stone2003;Ding2002;Jeffrys2006;andMiddendorf2007.
5 For an excavation report,see Hunansheng bowuguan 1974. For a docu
mentationofthefinds,seeMawangduixiaozu1980;1985.
6 / Chapter One
Tianxia). Theyraisedgreatacademicinterest,leadingtonew publications
andthusbringingthestudy ofsexintomainstreamacademia.
Essential studies include Ma Jixings Mawangdui gu yishu
kaoshi (Textual Research and Annotation of Ancient
Medical Booksfrom Mawangdui,1992)and DonaldHarpersEarlyChi
neseMedicalLiterature(1998).Mawasthefirsttoprovideafulltranscrip
tionandinterpretationofallfourteenmedicaltexts,whileHarpertrans
lated them into English with comprehensive commentary. The He yin
yangandTianxia havefurtherbeentranslatedanddiscussedbyDouglas
Wile (1992) and Rodo Pfister (2003). Another important work is Rodo
Pfisters forthcoming Sexuelle Krpertechniken im alten China (2011). Its
three volumes offer new translations and transcriptions of the sexual
manuals together with full philological annotation and extensive inter
pretationofancientphysiology.
Altogether, the manuscriptsshow thatsexandhealthinearlyChina
were closely related to the development of medical theory. Vice versa,
researchonthehistoryofChinesemedicine,anexpandingfieldofstudy,
continues to make significant contributions to the understanding of
sexuality. Key Western contributors include Joseph Needham, Nathan
Sivin,ManfredPorkert,andPaulUnschuld.Morerecentworks,suchas
InnovationinChineseMedicine,editedbyElisabethHsu(2001a),showthe
scopeanddiversityofresearchundertakentoday.
Exploringsexandsexualitywithinsystematizedandwelldevelop
edmedicaltheoriesoftheHan,IfollowtheancienttraditionofChinese
scholars and physicians who looked back to ancient knowledge for in
spiration and guidance.This isespecially trueformedical students and
practitionersofChinesemedicine,thenandnow.As MartaHansonsays:
TheChinesehaveconsideredtheHuangdineijing...tobethefounding
canonofChinesemedicinepasseddownfromtheYellowEmperorsince
unrecorded antiquity (2001, 264). Similarly, Elisabeth Hsu states that
scholars and doctors looked back to a Golden Age in the past Even
today, practitioners intent on modernizing Chinese medicine declare
allegiancetothecanonicaltraditionthatlinkstheminadirectlinetothe
legendary figure of the Yellow Emperor (2001a, 1). I am, therefore,
looking back to the past for knowledge to show that sex and health
playedaroleintheformulationofmedicaltheoriesintheHanbystudy
ingthe Suwen,the foremostChinesemedical textbook.
Sexual Culture in Early China

SincetheSuwenispredominatelyaHantext,itisimportanttoestablish
howsexisrepresentedintheperiodsbeforeandduringitscompilation.
Three categories of texts are relevant here. The first includes proto
medical and medical texts, such as those in the Mawangdui corpus as
well as materials related to the Suwen. They are probably the works of
officersand/orscholarswhoworkedatthecourtsofkingsandemperors
in different parts of China and strove to present their own brand of
medicalknowledge.TheMawangduitextsrepresentatransitionalphase
inthedevelopmentofmedicaltheories,whiletheSuwenshowstheirin
creased systematization.
Thesecondtypeoftextrefersexplicitlytosexualcultivation.These
aretheMawangduisexualmanuals, classifiedas textsonnourishinglife.
Open to a limited readership among the upper classes, they show that
the sexual act was a techniquetoprolong life,prevent illness,andcure
ailments.Theinfluenceofyangshengliteratureonthehistoricaldevelop
ment of Western Han Chinese medical theory has been well docu
mented.6
The last group of texts, which mention sex in passing, is found
amongcourtliterature,includingritualtexts,suchastheLiji (Book
ofRites);philosophicaltextsonnatureandhumanity,e.g.,thecommen
taries of the Yijing (Book of Changes), the great book of ancient
divination, and the Zhuangzi (Book of Master Zhuang), the second
majortextofearlyDaoistthought(dat.ca.290 BCE);anecdotalliterature,
e.g.,the Zuozhuan (CommentaryofZuo) and theLshichunqiu
(MisterLsSpringandFall[Annals]);poetryandsongs,suchasthe
Shijing, which depicts different local traditions; court poetry; the Chuci,
whichconsistsofsongsthatexpresssubjectivethinkingmixedwithreli
gious thought;mythologyas found in the Shanhaijing (Classic of
the Mountains and Seas); ideological writings that condemn sexual
decadence, e.g., the Lien zhuan (Biographies of Exemplary
Women); and dynastic history, such as the Shiji (Records of the
Historian)bySimaQian(14590BCE) andtheHanshu (History
6
See Lo2001,21;He andLo1996;Wile1992,19,23;Harper1998,7790.
8 / Chapter One
oftheHan)byBanGu (3292CE).Theseworksareamongthemost
importantandinfluentialliterarycreationsofChineseculture.Howthey
deal with sex provides insight into the dominant attitude and experi
encesinancientsociety.
Evidence that there was a welldeveloped sex culture in the Han
comes from the Hanshu bibliography (Yiwen zhi ; 30.177581).7 It
lists six categories, ending in prescription techniques (fangji ),
whichcontains36 booksinfour classes:1)medicalclassics(yijing);2)
classicalprescriptions (jingfang ); 3)bedchamber [arts] (fangzhong
);and 4)spirit immortals(shenxian ). Thebedchamber sectionhas
eighttitles:
1.
2.
3.
4.
5.
6.
7.
8.
RongchengsWayoftheYin
WuchengzisWayoftheYin
YaoandShunsWayoftheYin
TangandPangengsWayoftheYin
TianlaoandOtherMastersWayoftheYin
TianyisWayoftheYin
PrescriptionsforNourishing the Yang bythe Yellow
EmperorandtheThreeKings
Prescriptions of the Three Schools for the Inner
ChamberforBegettingProgeny
Thefirstsixbooksareabouttechniquesknownaswayoftheyin
or the hidden way (yindao ), which is another expression for the
bedchamberartsandalsomentionedin Shiwen#10,whenitspeaksofa
technique astheway ofbeing intimate[sexually] (jieyinzhidao
). Masters of this way included Rongcheng, Wucheng, Yao, Shun,
and others. The last two items provide prescriptions (fang ) for the
TheHanshuconsistsof100scrolls,dividedintofoursections:1)ji (An
nals),in12(13)scrollswithEmperorsbiographiesinstrictannalsform;2)biao
(Tables), in 8 (10) scrolls of chronological tables of important people; 3) zhi
Memoirs/Discoursesin10(18)scrolls,describingareasofstateeffort;andzhuan
biographies in 70 scrolls, documenting important people. Zhi further divide
intosixcategories:1)classicalbooksandcommentaries;2)philosophicalworks;3)
poems and poetic essays; 4) military texts; 5) astronomy, calendrics, and
divination;and6)medicalformulasandcures. SeeHulsew1993.
7

nourishing of male sexual energy and producing male offspring. The
editoraddsthefollowingnote:
The bedchamber arts constitute the climax of human nature and reachthe
supreme Dao.Thus the sage kings of antiquityregulated externalpleasure
andrestrainedinnerpassionbyhavingrulesforthispurpose[sexualinter
course].Itissaid:Theancientsusedtheir[sexual]pleasuretoregulatethe
hundredaffairs.Whenpleasureisregulated,therewillbeharmony,peace
andlongevity.Thosewhoarebewildereddonotreflect.Hence,theywillfall
illandharm theirlives.(Hanshu 30.1781)
ThisnoteindicatesnotonlythattheHanChinesehadatraditionof
sexualcultivationwhichcould betracedbacktooldrecords, butthatit
wastreasuredandbelievedtohavebeensanctionedbythesagekings.It
advocates that anyone practicing the teachings in these booksproperly
canattainlong life(shou). Failuretofollowtherules,ontheotherhand,
willleadtodiseaseandanearlydeath(yao ).Therefore,thepracticeof
thebedchamberartswasencouragedandconsideredasasupremeDao
(zhidao )thatoughttobeacquiredlikemoralexcellenceorvirtue(de
).ItalsoconnectstotheConfucianideathattakingcareofonesbody
andlivinglongarefilialqualities topursue.
AnothersourcewithaclearreferencetosexuallifeinHanChinais
the poem called Tongsheng ge (Matching Voice Song) written
byZhangHeng (78139)aboutabrideaddressinghernewhusband
onhernuptialnight.Thebridehasjustenteredtheinnerquartersandis
anticipatingtheirfirstsexualencounterwithexcitementandtrepidation,
asifabouttotouchboilingwater.Sheinformsthegroomthatshehas
madeallthenecessarypreparationsforanexciting,romanticeveningby
layingoutnewandcleanpillows,bedmats,andcoverlets,andfillingthe
burner with rare incense. She locks the double doors, sheds her robes,
removes hermakeupandhairornaments, and says:
[I]rolloutthepicturescrollbesidethepillows,
ThePlain Woman Ishalltakeasmyinstructress,
Sothatwecanpracticeallthevariegatedpostures,
Thosethatanordinaryhusbandhasrarelyseen,
SuchastaughtbyLordOld Yellow totheYellowEmperor.
Nojoyshallequalthedelightsofthisfirstnight,
This [night] shall never be forgotten, however old we may grow.
(VanGulik1961,73;alsoMiddendorf2007,9293)
10 / Chapter One
hepoemsuggeststhatpicturescrollsofsexualpositions(seeFig.1a
b) werepartofabridestrousseauandthatshewasexpectedtousethem
tosatisfyhernewhusband.UlrikeMiddendorfseestheuseoferoticim
ages, as they still survive from Ming dynasty sources such as the Sue
pian (SuEsTreatise;datca.1640),8 aspartoftheprocessual(sic)
nature of sexual intercourse, i.e., psychogenic stimulation, resulting
from erotic imagery or reading and viewing eroticabooks, paintings
andsoforth(2007,85).ZhangHengreferredtothesepicturescrollsin
anotherofhispoementitledQipian (SevenVolumes)(VanGulik
1961, 7677).
Fig.1a. Thesunandmoonunite
theirjadedisks. Suepian,no.19.
Fig. 1b. Jade mountain stands

alone.Suepian,no.35.
Psychogenic stimulation as part of sexual culture has continued

throughout thehistory ofChina. For example,theDalefu (Poetic
8 The Suepiantellsthestory ofMasterWu, a historical figure ofthe Tang
dynasty,andhisbeautifulconcubine,SuE.Thecoupleengagedinsexualinter
courseusingdifferentpositions,whichareillustratedwithwoodengravingsand
accompaniedbyverse.Thebookhas43chaptersin4volumes,with10,000char
actersand90illustrations. SeeKinseyInstitute;Murat1984.

Essay on Great Happiness) of the Tang says: They read the Sun jing
and look atthe eroticpicturesonthefolding screen.Settingthe folding
screensaroundthem,theyliedown,recliningonthepillows(Umekawa
2005, 258). Extant erotic picture scrolls and books tend to be from the
Ming(13681644)andQing(16441912)dynasties,testifyingtotheircon
tinueduse.
PoemsofboththeHanandtheTangnamethePlainWoman(Sun
)andLordOldYellow(Huanglao )assexteachers.Chapter28
of the Ishinpcontainsmany fragments oftextsassociated with the for
mer. The Ishinp is similar in style and content to the sexual manuals,
consideredtextualdescendants of theMawangduimanuscripts (Wile
1992, 84). There are many other masters of the bedchamber arts in the
WesternHan, asthefifthbookofthe bedchamberarts seriesintheYiwen
zhi testifies. The title Tianlao and Other Masters Way of the Yin,
moreover, is another indication the Heavenly Elder was a prominent
figure,notunliketheLordOldYellow.
ScholarshaveinterpretedtheancientChinesetraditionofincluding
sexual manuals in a brides trousseau as a sign that they had an open
and unabashed attitude toward sex. Given that Confucian ethics ruled
familylifeandthatancestorworshipandprocreationwereessential,itis
likelytobewishfulthinkingthattheChinesetreatedsexinaliberaland
lightheartedmanner.Whattheemphasisonpracticemanualsreallyre
veals is that the Chinese were practical about sex education for newly
weds so theycouldproperly perform theirduties to family andsociety
by producing many sons to perpetuate the family line. However, this
doesnotmeanthatpleasureanderoticismwereexcluded.
Heterosexual encounters were thenorm in Han life,but other sex
ual preferences existed. Bret Hinschs exploration of homosexuality in
ancient China leadshimtoconclude that itwas at leasttolerated,and
simplyaccepted,bythepoliticaleliteofZhouChina (1990,1532). Inthe
Hanitwasknownascutsleeve (duanxiu ),anexpressionthatgoes
backto EmperorAi(r.6BCE1 CE),who supposedly cutoffthesleeveof
his imperial gown to avoid waking his lover Dongxian who was
sleepingonit. 9
9 For more on homosexuality in China, see Hinsch 1990; Kapac 1992; Liu
1993,28798;Ruan1997,5766;VanGulik1961,28,48,6263,109.
12 / Chapter One
Bisexualitywaspracticedbytheelite.Historiansacknowledgethat
thefirstthreeHanemperorsthefounderGaozu(206195),Huidi(194
188), and Wendi (179157)were bisexual. Apart from regular sexual
adventures with numerous consorts and court ladies, they had sexual
relations with youngmen.AltogethertheShiji(ch.125) andtheHanshu
(ch.93) record tenopenlybisexualemperors(Hinsch1990,3454).
Referencestothecomplexityofthesocialfabricinrelationtosexual
life in Han court literaturearediverse, but theMawangdui corpus and
theancientclassificationofmedicalliteraturedemonstratethatsexwas
regardedasacategoryofphysicalandspiritualcultivation,andthatthe
categorizationaffectedeliteattitudestowardsex(especiallytheattitudes
ofelitemales,whoaredeemedthechiefbeneficiariesofcultivationprac
tices)(Harper 2005).Together with theSuwen andothermedical texts,
they provide a glimpse of some aspects of the aristocrats sexual life.
However,the absenceof specific worksdiscussingsex in the social and
intellectual framework of early Chinamakes itdifficult tobuild acom
plete or coherent picture of its role. Added to this difficulty is that re
cordswerecompiledbyandfortheelite,10 andinformationisscarceon
howordinarypeopleconducttheirsex lives.
Sex and Archaeology

Recent archaeological finds of erotic and sexual objects in Han graves
provide valuable information for the study of sexual culture in early
China.Themostintriguingincludeonesingleandtwodoublephalli(zu
)excavatedfromthetombofPrinceLiuSheng (d.113BCE).One
of thesonsofEmperor Jingde (188141) andhisconsort Dou Wan ,
hewastherulerofZhongshan.Histomb was discoverednearMancheng,
Hebei,in1968.
10 Harper notes: Who read these manuscripts and who made use of the
recipes,isacomplexissue.However,itisfairtoassumethatthesemanuscripts
werewrittenbytheupperechelonofsocietysuchasphysicians,intellectualsor
menofwordsandreadbytheircolleagues,whowoulddisseminatetheinfor
mation tothe general populace as aphysician would advise hispatient (2005,
93).

Thesinglephallusismadeofsilverandhollowinside,andthetwo
double phalli are of solid bronze (see Fig. 2). They were found in the
middlechamberofthetombcomplexandmayhavebeenusedforcere
monialpurposes(Eggebrecht1994,#95).However,giventhatLiuSheng
was known to indulge in alcohol and womenhe is rumored to have
had120sonsitshouldnotbesurprisingtofindobjectsheorhisconcu
binesused.Butwhatexactlytheywereandhowtheywereusedremain
subjectto speculation.
Fig.2. PrinceLiuShengsdoublephalliwithovalstones.
Comparingtheangleof an erectpenis to thatofthedoublephalli,

Rodo Pfister speculates that two women could use them to pleasure
themselves atthesametime (2011, I:2.35)11.Laterillustrationsfromthe
Ming show a pair of women using double olisbos, made of wood or
ivorywithtwosilkbandsattachedinthemiddle(VanGulik2004,Pls.IV,
XVII; 1961, 163).A. andE. Franzblau showhow the single phallus was
ingeniouslyusedbyawomantosatisfyherself(1977,#39,#36)andnote
that these devices were much used in the Ming. Yimen has a good de
scription of what an ivory double dildo looked like and how a single
dildo wasusedbytwowomen(1997,172,180).
Archaeologists also found two offwhite eggshaped objects made
ofstonenexttothetwodoublephalli. Someresearchersbelievethatthey
symbolise the testicle. Pfister thinks that women used them for sexual
11
Thenumbersrefertovolume,section,and subsection.
14 / Chapter One
cultivationortopleasurethemselves(2011,I:2.3.25F2).12 Mostscholars,
however, believe that Liu Sheng and his women used these articles in
theirlifetimes.
Archaeological excavations in Shaanxi reveal other intriguing sex
ual aids: contraptions made of bone and iron that look like miniature
cradles forpenises 13 (seeFig.3a).
Fig. 3a.Peniscradles.
In addition, various bronze dildos were excavated at the site (see

Fig. 3b). They are hollow and crafted in fine detail. It is hard to say
whether they were to be usedby men or women, alone or in combina
tion. Some Chinese scholars speculate that they were medical instru
mentsusedintreatingfrigidityorassexualaidsforintercourseinplace
of the male member. Most believe that the owner of the tomb (male or
female?)utilizedthesesexualaidsinhisorherlifetime.Othershypothe
sizethat the contraptions wereused by awomantopleasure herself,bya
healthy man for sexual stimulation, by a man with sexual dysfunction
forsupport,orbyaeunuchorothercastratetosatisfyhisdesires(Song
2004,2:19).
12 On sexual aids employed by women for self pleasuring, see Van Gulik
1961,16336.Onlesbianism,seeHinsch1990,17377.
13 TombM54isoneofover90tombsfoundinthenorthernpartofXian,in
the suburb of Zhengwang Village, excavated in 2002. According to the excava
tionteam,thetombdatesfromtheearlyWesternHan.SeeSong2004,2:1519.
Fig.3b.Bronzedildos.
ChenHaispeculatesthatwomenusedthepeniscradleforstimulationof
the Gspot and adds that itcan also becombined with the dildo (2004,
3:6267)(see Fig. 3c).Although there areno written outlines ordescrip
tions of their use, given the precision and ingenuity with which they
weredesigned,theymusthaveplayedanimportant roleintheirowners
life.
Fig.3c.Thecombineduseofcradleanddildo.
Just as interesting and intriguing are the beautifully carved phalli

protruding horizontally from heads of humans, deer, monkeys, ducks,
cows,pigs,andeagles clawsfoundinrelicsof theDian culture,which
flourished in southwest China during the Western Han (175109 BCE).
ThestateofDianisfirstdocumentedfromtheBronzeAge,whenitwas
located in presentday Yunnan around the Dian Lake in the upper
reachesoftheYangtzeRiver.Lastingfromabout1,000BCEtotheearly
16 / Chapter One
Han, it saw its prime during the Spring and Autumn period (770479
BCE). Though Dian has been considered as a fringe culture of Chinese
civilization, it was strongly influenced by the Shu and Chu cultures
(Mawangdui and Zhangjiashan).With itsanimisticreligion,ithasleft a
wealthofceremonialarticlesbehindmosteroticobjectsbeingfromLi
jiashanandYangpudou(Yang2002).
Grave M113 contains various animal or human heads with phalli
protrudingfromtheirbacksornecks.Thecreatorsoftheseeroticobjects
paintedthephalliinbrownishredandthenonphallicpartsinblacklac
querwithbrownishredresintofillindetailssuchashairsandfeathers.
Otheritemsinthistroveinclude:asmallshovelwithaphallusashandle
plustesticlesoneithersideasit(seeFig.4).
Fig. 4.Shortshovelwithphallichandle.
Evenyearsaftertheirdiscovery,littlehasbeenwrittenaboutthese
objects.However,judging fromtheir artistry, theirassociation withdo
mesticanimals,andtheirubiquitousdepictionofcommonsituationsand
application in household articles, phallus worship or fertility rites
formed an important part of their tradition.14 Again, being grave goods
andwithoutanywrittencontextordescription,itisdifficulttoascertain
Foradetaileddiscussiononphallicisminconnectiontotheearthgodin
China,seeEberhard1968,18889.SeealsoKarlgren1930;Waley1931.Onzu
asthephallicgodoftheancientChinese,seeHentze1951,1718.Formoreonthe
societyoftheOrchidTower(Lanting),wheremen,oldandyoung,meetto
practiseharmonisingqirituals,seeBischoff1985,4.
14

theiruseandpurposeortodrawanyconclusiononsexual,social,orre
ligiouscustoms.
Other archaeological finds of erotic objects in Han graves include
figurines and relief drawings depicting embracing and/or kissing cou
ples. In 1987, archaeologists fromHejiangCounty inSichuan excavated
thefigurineofanembracingcouplemadeofredclay(XieandXu1992,
48).Astonerelief depicting a kissingcouple wasfound in Leshan(Lim
1987, 130); another, of a man kissing a woman with his right arm over
her shoulder and his righthand on her breast, was unearthed in Peng
shengin1942(1987,131;seeFigs.5ab).
Fig.5a.Kissingcouple.
Fig.5b.Intimatecouple
In 1972, archaeologists further unearthed stone drawings of an in

timate scene in which a man and a woman, kneeling in front of each
other,areholdinghandsand kissing.Theydecorateone sideof a stone
coffininRongjingCounty,Sichuan(Lim1987,128;seeFig.5c).Another
intimate scene of a man and woman embracing in the presence of two
otherswasfoundinFayangCounty,Sichuan.Reliefdrawingsoncoffins
often illustrate scenes from the life of the deceased, which could mean
that intimacybetweencouples inpublic was an accepted socialcustom
(1987,129;seeFig.5d).
18 / Chapter One
Fig.5c.Kissingcoupleunderarches.
Fig.5d.Intimatecoupleinsocialsetting
The most sexually explicit objects among recent archaeological

finds include two bricks or tiles with illustrations found in an Eastern
HantombatXindu,Sichuan.15 Theyhavebeenvariouslycalledpicture
of pleasure under the mulberry tree (sangle tu ), mating in the
wild among the mulberries (sangjian yehe ), picture of mating
inthewild(yehetu ),andpictureoftheSupremeIntermediary
15 Working on a Sichuan mountain slope in 1979, builders came across a
brickgravefromtheEasternHanwithmorethantenbricksdecoratedwithvari
ousthemes.SeeXie1992,48;KulturstiftungRuhr1995,41113;Rawson1996,202.

(GaoMeitu ).ChenLeiarguesthatthelatternameismostappro
priate because he believes that the custom had its origin in the rite of
connecting acouplethrough an intermediary, whereas the othernames
convey only the activity and location but not the tradition or religious
background. Mulberry is often associated withthespring seasonand is
mentionedinconnectionwithotherfertilityritesintheHan(1995).16
The first brick shows three naked men with full erections and a
womanlyingonherbackonthegroundwithherlegsspreadeagledun
der the canopy of a luxuriant [mulberry] tree; the second seems like a
continuationofthesexualencounter:twomenhavesatisfiedthemselves
and look as ifthey arerecuperating, while thethird is still in thecoitus
position(seeFig.6).
It is possible that these two erotic scenes represent remnants of a
Spring Festival dating from the Zhou era, in honor of the Supreme In
termediary,whenyoungmenandwomencametogethertomateinna
tureintheancientfertilityritecalledmatinginthewild.
16 SeealsoBodde1975,24360;Eberhard1968,13032;ChenY.1995,1820;
andHong1995,6062.
20 / Chapter One
Fig.6.GaoMei illustratedbricks.
Confucius (551479 BCE), amazingly enough, was the product of

such an encounter. Sima Qian states that his father mated with a
womanfromtheYantribeinthewild[underthemulberrytree]tobring
forthConfucius(Shiji47).Therearenorecordsofhimhavingsuffered
discrimination because of this conception. Either the custom was com
mon practice and widely sanctioned in ancient China or later editors
haveextirpatedallevidencetohisquestionablesocialstatus.
However, without anyconcrete evidencethatlinks objects to writ
ten sources, it is difficult to know what the archaeological evidence
represents.Furthermore,beingfuneraryobjects,itishardtoknowifthe
itemsrepresentanaspectoflifeorwhethertheyaremeantfortheafter
life (Berger 1988, 4653). Despite all this, thearchaeological findsare in
triguingand reflect thevarietyof attitudes toward sexintheHanera.
Since many eroticobjects werefoundinthewesternpartofChina,it
ispossiblethatthisregionhadadifferentviewof,andattitudetoward,
sex. The biography of Sima Xiangru (179117 BCE), a young
manfondofwomen,wine,andswordfighting,strengthens thisassump
tion,whenitdescribeshowhedefendedhimselffromaccusationsofbe
ing lecherous by saying that he grew up in the west, implying that

sexual matters were viewed differently there.17 These diverse archaeo
logical objects show that sex as revealed by archaeology is a relatively
unexploredareathatawaitsfurtherattention.
All these sources, though limited in range, still reveal certain as
pectsoftheHanperceptionofsex.Wearenotsurehowthesexualcus
toms and attitudes fit into thesocialmilieu of thetime,butit iscertain
that their understanding does not fit into Websters and other modern
definitions.AsKristoferSchippersays:Itisnonsensetothinkthatsexu
alityintraditionalChinawaspracticedfreely(1993,146).Sexinancient
China belongs to an encompassing sexhealthmedicinecomplex that is
partandparcelofChinesethinking.Thereisnobetterbooktostudythis
interconnectednessthanthe YellowEmperors Basic Questions.
17 See Harbsmaiers translation of the Meirenfu (Poetic Essay on

Beautiful Women), preserved in the Song collection Guwen yuan (1995,
36557).SeealsoVanGulik1961,6769.
Chapter Two
The Yellow Emperors Text
Once the disease has manifested itself, it is too late to seek a
physician. It is like starting to dig a well when one is thirsty or
starting to forge weapons after war has broken out.
Suwen
The correlation of sex, health, longevity, and medicine is well exempli
fiedintheSuwennotonlybecauseitisoneoftheearliestChinesemedi
cal textsbutbecauseof what itrepresents in Chinesemedicine.Almost
every medical work cites it in some way or another, and traditional
physicians have regularly presented later innovations as supplements
tothesefoundingcanons[SuwenandLingshu](Hanson2001,263).Cit
ing the Suwen is an established tradition of medical writers, beginning
withZhangJis (150219CE)Shanghanlun (DiscourseonCold
Disorders) and Sun Simiaos (681782) Qianjin yaofang
(Essential RecipesWorth AThousand Pieces of Gold, 7th c.),continuing
tothepresentday.
Doctors and authors of Traditional Chinese Medicine (TCM) still
considertheSuwenas thehistoricalrootoftheircraft.1 Infact,theoryand
methods of TCM arequite different. Modern practitioners are not usu
allyfamiliarwiththetext,andalmostallstudentsaretrainedwithtext
books that cite the Suwen only in support of the modern allopathically
acceptableversionofChinesemedicine.
Despite that, interest in the Suwen has generated many scholarly
projects(Sivin 1993, 196215). Studiessuch as Keiji Yamadas The For
1 See Hsu (1999, 16878) for the use of the classics in China today. Wang
Hongtu(1999,2)andAkahori(1989,19)notethatitstillservesasatextbookin
someschoolsofChinaandJapan.
22
The Yellow Emperors Text / 23

mationofthe Huangti neiching(1974)andDavidKeegansdissertation
on its structureand compilation (1988) havepaved the way for critical,
philological research.MostambitioustodateistheSuwen Project,initi
ated in 1990by Paul Unschuld at the Institute for the History of Medi
cineattheLudwigMaximiliansUniversity inMunich.2 Hesays:
ReadingtheSuwennotonlyincreasesourunderstandingoftherootsofChi
nese medicine as an integral aspect of Chinese civilization. It provides a
much needed startingpoint for serious and wellinformed discussions on
differences and parallel between European and Chinese approaches to es
sentialthreatssuchasillnessandtheriskofearlydeath.(2003,x)
Since the start of the project, scholars have collected and indexed
over 3,000 articles from Chinese periodicals as well as over 600 mono
graphs by Chinese and Japanese authors (Tessenow 2002, 649). In the
initialstages ofmyresearchIbenefitedmostfromtheconcordancetothe
text (Ren 1986) andthe extensiveresearch summary (Wanget al.1997).
Thelatter,inparticular,documentsthetremendousinterestandscopeof
Suwen studies undertaken over the centuries. They show that health,
sickness, and the riskof early deatharecloselyconnected to sexual en
counters in the Chinese mind. However, scholars have not paid much
attentionto the connections betweensex,health,longevity,andmedicine
in the Suwen despitetheir growing interest inthe Mawangduimanuals
andthehistoryofmedicine.
Sex being a fundamental need means that understanding it is im
portant forcomprehending humanbehavior, which in turn leads to the
study and development of medical theories. The lack of interest in ex
ploring this connection may be due to the scholarly perception of the
Suwenasamedicalbookdealingonlywithmedicalaffairs.Asthisstudy
will reveal, however, medical theories are influenced by doctrines on
nourishing life, of which sexual cultivation is a branch. The fact that
thereisnoexactwordfor sexinearlyChinese mayalsobeacontribut
ing factor. The text alludes to sex through its function in relation to
2 Twobookshavesinceappeared:Unschuld2003;TessenowandUnschuld
2008. Two further volumesare in preparation: an annotated English translation
ofthecompletetext,andtechnicalaidssuchasconcordances,glossary,andan
notatedbibliography.
24 / Chapter Two
medicaltheoriesorsocialnorms,suchaslifestyle.Itsprinklesthenotion
ofsexandsexualityover 37 of its 79 chapters.
However, despite these obstacles, it is still important to undertake
this study because the Suwen represents the shift from protomedical
thinking, such as found in the Mawangdui medical corpus, to well
defined and systematized medical theories on which Classical Chinese
Medicine (CCM) and TCM base their foundations.3 As Yoshinobu Sa
kadenotes,TosolveanyproblemrelatingtoChinesetraditionalmedi
cine, a thorough knowledge of the medical classics of the Yellow Em
peror,theSuwenandtheLingshu,isabsolutelyindispensable(1989,20).
SimilarlyGweiDjenLuemphasizesthatnorealunderstanding[ofChi
nese medicine] can be attained without the basis of the Huangti nei
ching (1980, 9). Hence, it seems appropriate to start with the Suwen in
order to studysexandhealthinearly medicaltheories.
Thisiseasiersaidthandone.AsNathanSivinnotes,nopublished
translation of any substantial part of the Huangdi neijing meets current
standards for the establishment of a critical text, philological accuracy
andafaithfuldepictionofconcepts(1993,207).Thiswasstillthesitua
tionin2002whenIstartedmyresearch.Therewereonlyfourcomplete
and various partial translations in English. In addition, none of these
translationsare basedonphilologicalstudies,sothattheyhaveonlylim
itedvaluefortextual,historical,and philologicalanalysis.
How, then, can we find sex in the text if there is no word for it?
Therearemanytermstolookat.Forexample,havingsexisexpressed
either euphemistically, e.g., entering the bedchamber (rufang ),
symbolically,e.g.,penetrateorinner(nei),ormetaphorically,e.g.,
hidden twists (yinqu ). Since the Suwen is not a sexual manual,
It is importantto differentiate CCM from TCM. TCMtoday, with its no

menclature based on Western biomedicine, is a development of CCM, a new
phenomenon of the late fifties.Hsu defines TCM as revised Chinese medicine
that has been promoted by the government of PRC (1999, 168223). For more
discussion of how TCM was created, see Fruehauf 1999; Farquhar 1994; Sivin
1987,1623;Unschuld1985,22962.CCM,ontheotherhand,canbetracedback
thousands of years to inscriptions in oracle bones (14th 11th c. B.C.E.). Some of
these arestillpart ofthe medical vocabulary in thescholarlytradition.SeeUn
schuld1985forthehistoryofhowChinesemedicalthoughtdevelopedsincethe
Shang;seeHsu1999onhowthepracticeistransmittedtoday.
3

terms relating to sex are scattered throughout the book and subsumed
withinmedicaltheoriesrelatingto the causesandetiologyofdiseases.
Also,passagesrelatedtosexualityareusuallyhiddeninothercon
texts. To find them, I started by identifying obvious terms that reflect
reproductivephysiology.Theyincludeenteringthebedchamber(rufang),
urological system (shen , kidney), jing usually translatedessence,
ConceptionVessel( renmai),PenetratingVessel( chongmai),Gov
erning Vessel ( dumai), testicles(luan ), scrotum (nang ), breasts
(ru ),uterus(bao),fetus(tai), menstruation(yueshi), fertilityor
pregnancy (youzi), andother,similar terms.
After identifying theseterms, I usedRen Yingqiusconcordanceto
find passages that contained them.4 In addition, I familiarized myself
with theories and terminologies of CCM and TCM associated with ob
stetrics,gynecology,reproductivephysiology,sexualdysfunction,sexual
anatomy, and other relevant components. I also studied early Daoist
textsthatmentionsexualcultivation.Thepassagesselectedinthisstudy,
then, are the result of these crossreferences. Since the sexual manuals
found at Mawangdui share the closest zeitgeist with the Suwen, I used
themforcomparison.
Accurate and faithful translation from one language to another is
alwaysdifficult,butevenmoresowithatimelapseofover2,000years.
In his book WhoTranslates? Douglas Robinson sets up a series of post
rationalist perspectives to explain this experience: every translator, he
says,hasadifferentexperience;manyrecognizethattheirworkissome
timesgovernedbyforcesbeyondrationalcontrol(2001).Asformyown
translations, I use the three different categories recommended by Con
stantinMilsky:1)transliteration,2)literalandsymbolictranslation,and
3) explanatory translation (1989, 7980). Sometimes the translation may
seemstiltedorgrammaticallyillogical,butthatisbecauseIaimforphi
lological accuracy and forgo elegance in style. The interpretation and
elaborationofmedicaltheories,Ileaveto the medicalscholars.
4 Iusethistorefertothetext.Forexample,1.3.1referstoSuwench.1,Sec
tion3,Paragraph1.Lingshu passagesfollowthesamenumberingsystem.
26 / Chapter Two
Early History
TheSuwenisacomplextext,andscholarshipregardingitscreationcon
tinuestothisday.ThebibliographicsectionoftheHanshulistsseventi
tles under the heading Prescription Techniques in the section on
Medical Classics. Theyare:
1. Huangdineijing
2. Huangdiwaijing
3. BianQueneijing
4. BianQuewaijing
5. Baishineijing
6. Baishiwaijing
7. Pangpian
HuangdisInnerClassic,18 scrolls
Huangdi OuterClassic,37 scrolls
BianQuesInnerClassic,9 scrolls
BianQuesOuterClassic,12 scrolls
MasterBaisInnerClassic,38 scrolls
MasterBaisOuterClassic,36 scrolls
Appendedchapters,25 scrolls
Mostofthesearelosttoday,buttheyallrefertomajormedicalormytho
logicalfiguresastheirkeyprotagonists.
Who,then,isHuangdi,theYellowEmperor?Howdidhecome
topaysuchabigroleintheNeijing?Amythicalculturehero,SimaQian
nameshim astheoriginalancestorofthe Chinesepeopleandhe isstill
worshipedassuchathisallegedbirthplaceinHenantoday.TheHanshu
mentionshiminworkslistedunderthecategoriesofDaoism,yinyang,
five phases, military arts, calendar, astrology, medicine, sexual cultiva
tion,immortality,andmany more,makinghimawellknownandpopu
larfigureatthetime(Peerenboom1993,3).
It seems natural and logical to dedicate a medical text to such an
august figure.The otherreasoncouldbepolitical.Medicalmanuscripts
excavatedfromMawangduiandMianyangtestifytothefactthatdiffer
entkinds ofmedical knowledge weredisseminated across geographical
andcultural regions (Harper 1998, 3036). Elisabeth Hsuconcludesthat
from the beginning the medical authority of the elite did not present
itselfasahomogenousunity(2001a,17).ThisissupportedbytheShiji,
whichnotesthattheWesternHanphysicianChunyuYi ,anative
ofthestateofQi, had rivalsbothinternalandexternal(105.2)imply
ingnotonlythattheywerefromdifferentschoolsbut alsofromdifferent
regions. PreSuwen medical knowledge appears to have come from dif
ferent lineages and localities; the Suwen confirms that different tech

niquesofcuringdiseasesoriginatedfromdifferentpartsofChina(12.1).5
Itispossiblethatinordertopleaseallthefactionsand lineages,themost
neutralandbestsolutionwastolinkthemedicalclassicwiththeYellow
Emperor.
Thequestion whethertheHuangdineijingmentioned in theHanshu
is the same or related to the text extant today is still under discussion.
The surviving texthas hadthe samecollective title for both Suwen and
Lingshu only since the NorthernSong (9601179); it isoften abbreviated
Neijing. According to Nathan Sivin, the title Huangdi neijing usually
comesbeforeSuwen(BasicQuestions),Lingshu(SpiritualPivot),Taisu
(GreatSimplicity),and Mingtang(HallofLight). He adds:
Critical scholarship over many centuries has established that none of the
fourisapristineHantext,andthatnoneisafabrication.Theissueisrather
the violence done in each case by editors aimingto restorethetext.All ex
cept theSuwenare Tang or Song reconstructions from recensions and frag
ments of Han origin. Although the Suwen was not lost, it shows signs of
moresubstantialrevisionbyitsTangandSongeditorsthantheotherbooks.
(1993,196)
TheearliestlistingofatextentitledSuwenappearsintheprefaceof
ZhangJisShanghanlun(ca.200).AsMartaHansonnotes,Chinesephy
sicians have traditionallyconsideredtheNeijingtobethe foundation of
medicaltheoryandtheShanghanluntobethebasisforclinicalpractice
(2001,263).ZhangJi confesses thatincompiling theShanghanlun,
Ihavediligentlysoughttheguidanceoftheancients;comprehensivelycol
lectedagreatnumberofrecipes,widelycollectedthevariousremedies,and
consulted the Suwen, Jiujuan (Nine Scrolls), Bashiyi nan
(Eightyone Difficult Issues, i.e., Nanjing), and Yinyangdalun (The
GreatTreatiseonYinYang),etc.(Mitchellalet.1999,29)
ItistemptingtoreadSuwenjiujuanasTheSuweninNineScrolls
but,asYuZihanargues,thephraseshouldbereadasindicatingtwodif
ferenttexts,theJiujuanbeingapredecessorof,oridenticalto,theLing
shu(Unschuld2003,6).
5 EberhardnotesthatancientChinesesocietyemergedfrominfluencesofa
numberoflocalculturesandenvironmentalsystems,whichbroughtdistinguish
abletraitsintoeventualcommonSinicstock(1968,131).
28 / Chapter Two
Notlongafter,Huangfu Mi (215282CE)wrote the prefaceto
his Jiayi jing (Classics of A and B), noting that the bibliographic
sectionoftheHanshulistsaHuangdineijingin18scrolls(juan).Headds
thatinhistime,theyhadaZhenjing (NeedleClassic)in9scrollsand
aSuwenin9scrolls.Togetherthesemadeup18scrollswhichmayhave
constituted what was listed earlier asNeijing.HementionstheZhenjing
inhispreface,butonlyusestheJiuquan inhiswork.Giventhesimilarity
ofcontentoftheJiayijingandtheLingshu,itispossiblethattheJiujuan,
Zhenjing, andLingshu allgoback tothesame original text.
NoeditionoftheLingshuhassurvivedpriortothe12th century,and
allcurrentversionsarebasedonShiSongseditionof1155.Theearliest
extant edition appeared under the Yuan Dynasty (133940) from a
publishinghousecalledGulinshutang (Sivin1993,206).Acopy
ofthiseditionispreservedattheNationalLibraryinBeijing(Zhongguo
1991,1,#4).
What,then,happenedtotheHuangdiwaijing,theOuterClassic,af
ter it was listed in the Hanshu bibliography? David Keegan discounts
FangYizhis andIlzaVeithsinterpretationthatneimeansinside
the body, hence internal, as in internal medicine, and that the Waijing
discussesexternalheteropathies(1988,910).JosephNeedhamthinksnei
means corporeal and wai means incorporeal (1959, 27172). I think that
theNeijingwasprobablytheworkofscholarphysiciansmeantformem
bers of the elite associated with the court, whereas the Waijing was a
handbook forthosewho treated themasses:itinerantdoctors known as
skillmasters(fangshi )describedinthedynastichistories(DeWoskin
1983,42)andcommondoctors(zhongyi )mentionedbyChunyuYiin
the Shiji. Both these groups were supposedly inferior in their practice
(Hsu2001a,5).
Fangshihadskills inthe techniques ofmedicine,divination, astrol
ogy,calendarcalculation,magic,exorcism,sexualcultivation,andsoon.
Theyalsohadtalentsofstorytellingandpoliticalpersuasion(DeWoskin
1983, 2324). First documented in the 3rd century BCE, they were often
fromoutlyingareasandpursuedpracticesdistinctlydifferentfromcourt
orthodoxy.Medicalskillmasters,incomparisontoelitephysicians,were
assignedalowersocialstatusbecauseoftheirexorcisticandmediumistic
practicesperformedamongthecommonpeople.
ThisdifferenceisobviousintheSuwen,wheretheYellowEmperor
learnsthattheskillmasterscouldnotdifferentiatetheinnerorgansand

viscera or bowels (zangfu ) (11.1). It implies that they did not have
the same medical knowledge as the scholarphysicians. Their inferior
status is further emphasized when the Yellow Emperor says that he
originally bestowed words from the classics or techniques on them,
but when they put them to use they were not completely successful
(74.5.1)again implying that they were less able than the physicians.
The Yellow Emperor brings the inferior status up once more when he
commentsthat thefangshihadnotreachedthe standard in skilltotreat
coldinduced diseasesanddidnot understandmedicaltheories(74.5.4).
It isobvious from thesepassages thattheSuwenphysicianslooked
down upon the skill masters and considered them outsiders (wai) as
opposed to being the elite of the inner circle (nei). One possible sce
narioisthattheWaijingwascompiledwhilethefangshihadsomeinflu
enceatcourt,forexample,duringthereignofEmperorWu(14086BCE)
(DeWoskin 1983, 4). However, after his death they lost their influence
andtheinnergroup,whodominatedtheofficeresponsibleforthecom
pilationofrecords,begantheirsystematicousting.Intheprocess,medi
calmen of skills were marginalized by elite physicians and theWaijing
wasgraduallyincorporatedintotheNeijingordoneawaywith entirely.
Hermann Tessenowpointsout thatthe innertradition has survivedbe
causeit wasconsideredmorecentral [and] important.Shortof anew
discovery of a manuscript that contains the Waijing, the question of its
origin,content,andfatewillcontinuetoinvitehypotheses.Thecompila
tionofthe Suwenis comparatively easiertotrace.
Compilation and Title

TheSuwen is written in the form ofacatechisma textualcommentary
inquestionandanswerformat.Ofthe79chaptersordiscourses(lun)
inthe receivedversion, 68arestructuredasdialogue betweentheYellow
Emperorandhisthreeministerswhoserveasinterlocutors:QiBoin 60
dialogues,LeiGong in7,andGuiYuqu in1(Unschuld2003,
8). TheLingshuand Taisu arewritteninthesameformat.
Tessenow hasconducted a thorough analysis of thestyle andcon
tentoftheSuwencomponentsbycomparingitwiththeTaisu intermsof
rhymestructure,dialoguepatterns,and commentaries.Hehasalsoiden
tifiedinsertionsby editors andcompilers. Henotes thatmanypassages
30 / Chapter Two
arerhymed,probablybecausetheycamefromoraltransmissionafea
ture not always easy to recognise since the pronunciation of characters
haschanged(2002,649).TheLingshu confirmsthatoraltransmissionwas
partofthemedicaltradition(28.1),andDavidKeeganconcludesthatthe
Suwenismadeupofmanyhistoricallayers,whichheidentifiesascom
pilationsofcompilations(1988,64).
Itispossiblethatsnatchesofmedicaltreatises,whichhaveescaped
theliterarybonfireorderedbytheFirstEmperoroftheQinin213BCE,
became part of his systematization and standardization campaign. The
processpermeatedeveryfacetofearlysociety:notonlyaxlewidth,legal
codes, weights, and measures were standardized, but script and litera
ture,too.Therefore,thecompilationoftheSuwencouldhavestartedoff
withthis unificationspirit.
AnotherpossibleimpetustocompilationwastheedictofHanEm
perorCheng(r.327BCE).In26,heorganizedagroupofmedicaloffi
cials headed by thecourt physician Li Zhuguo to collate and re
vise the imperial collection of medical books preserved at the national
library(MaKW1989,7).ThecompilationoftheSuwenmaywellbethe
fruitofthisfirstgovernmentsponsoredcollationandrevisionofmedical
works. The formation and compilation of the Lunyu (Analects) of
Confucius)(Makeham1996)andZhoubisuanjing (Mathematical
Classic of the Zhou Gnomon) came about through the same procedure
(Cullen1996,14856).
Among the three dialogue partners of the Yellow Emperor, Gui
Youyiappearsonlyinchapter66.BeingapossibleadditionbytheTang
editorWangBing (fl.762),thismayrepresentalaterlayer.Similarly
Lei Gong only appears from chapter 76 onward and may thus indicate
another layer. The Lingshu has three further figures:Bo Gao , Shao
Yu , and Shao Shi . This suggests that there were several sub
groupswhichdeveloped various doctrinesyetweresubsumedunderthe
Yellow Emperor lineage, which remained dominant. Keiji Yamada be
lieves that Shao Shi as the teacher of the Yellow Emperor signifies the
earliestlayer.BoGao,in10discourses,tendstobeassociatedmorewith
anatomy, whereas Qi Bo is generally linked with questions of the uni
verseand thetechniquesof acupuncture (1979,8788).
Each faction must have accumulated the results of their observa
tionsandinvestigationsofvesseltheoryandclinicalpracticeoveralong
time and summarizedtheir findings in variousmanuscripts. Theywere

eventually brought together into one compilation, which represented
diverseandcontrastingopinionsonexistingmedicaltheories.Intheend,
theYellowEmperorSchooltriumphedand cametodominatetheSuwen.
Thetext couldthus havestartedasaprotocompilationinthe3rd century
BCEunderadifferentname,tobethencompiledandrecompiledunder
the titleSuwen.
In sum, it is difficult to say how the Suwen was structured before
WangBingrewrote,reedited,reorganised,andexpandeditintheTang.
WangBingcreatedhisSuweninasociallyandpoliticallyunstablemilieu
caused by the rebellions of An Lushan and Shi Siming
between 755and763. It is as ifheneeded to emphasize thatonehas to
take ones life into ones ownhand andberesponsible for oneshealth.
Thus,heconsciouslymovedthosechapterspertainingtonourishinglife,
living in harmony with nature, and preventing diseases to the front of
the book, engendering a mindset appropriate to his time. Doing so, he
showedthatmedicaltheorieshadtheiroriginindoctrinesonnourishing
life.
The dating of the early Suwen is aided greatly by the Mawangdui
manuscriptswhich provideevidencethatChineseclassicalmedicinewas
still at the stage of forming pathological and physiological theories
around168BCE.BoththeZubishiyimaijiujing (Cauteriza
tionClassicoftheElevenVesselsofFootandForearm)andtheYinyang
shiyi mai jiujing, jiaben (Cauterization Classic of the
Eleven Yin and Yang Vessels, Version A) mention only eleven vessels
whereastheSuwendealswithtwelve.IntheWushierbingfang
(Fifty Two Recipes)there isnomentionofthe fivephasesdoctrine and
the yinyang theory is only implied in its rudimentary form in the ex
pressionspin (male)andmu (female).Thereislittlementionofthe
organsystem.Butthemosttellingisthatnoacupunctureormoxapoints
appear anywhereinthetext.
Incontrast, thevariouspoints inthe Suwen areclearly named and
allocatedandthe various vessel theoriesare systematized.Chapters 10,
11,and13oftheLingshugiveafulldescriptionofthevesselsystem.No
doubtSuwenmedicalthinkingisof anotherlevelthanthat propagatedin
theMawangduimanuscriptsand thatadvocatedby the Mianyangphy
sicians,whosesystemisdocumentedinabronzefigurinewithnineves
selsunearthedinSichuan.
32 / Chapter Two
Scholars such as DonaldHarper (1998), Vivienne Lo(2001),and Li
Ling (1993) agree that the medical theories as documented in the
Mawangdui manuscripts were still in the making, which indicates that
the Suwen was compiled after Mawangdui. Most scholars concur that,
judgingfromthestyleofwritingandthelanguageused,thecompilation
of the text could not have taken place before 100 BCE, although ideas
andconceptsareolderpossiblydatingbacktotheWarringStates.6 Ar
gumentsthatsupportthisassumptionincludethefactthat noversionsof
the text are mentioned in the Shiji of 104 BCE, not even in the biogra
phies of famousphysicians (ch.105).
The earliest mention of the Huangdi neijing is in the Qilue
(SevenSummaries)catalogueoftheHancourtlibrary,supposedlycom
piledbyLiuXin (46BCE23CE),whoarrivedatcourtinChangan
in26BCE.BanGu(3292CE),too,listsitintheHanshu,presumablyon
the basis of the Qilue, in the subcategory medical classics. Provided
thatthesematerialshavesurvivedinthepresentSuwen,itwasfirstcom
piled aroundthebeginningoftheCommonEra.
There isstillnoconsensus withregard to themeaning of the term
suwenwhich has been translated variouslythe word su going back to
the ideaofplain silk and thusmeaning simpleorplain(Wile 1992,
227n2). Modern scholars such as Kristofer Schipper (1993, 10001), Gio
vanniMaciocia (1994, 685), and Yang Shouzeng(1997,372)have trans
lated it as Simple Questions. Nathan Sivin bases his reading on the
firstcommentator,Quan Yuanqi (6th c.), who glossessu as ben ,
i.e.,basic (1997, 454) andtranslates it asBasicQuestions.He is fol
lowed by Unschuld (2003, 1821), Hanson (2001, 262), Despeux (1989,
128), Hsu (1999, 8), and Furth (1999, 20n2). Other variations include
Candid Questions (Porkert 1974, 359) Questions about Living Mat
ters(Lu1980,1), and PlainQuestions.
Sincethereisnoagreementastothemeaningoftheterm,thecon
tentofthebookmight provide some hint.NathanSivinsums it upas:
Aviewoftherelationbetweenthecosmos,theimmediateenvironment,and
the human body and emotions, of the relation between living habits and
health, of body contents, of vital and pathological processes, of signs and
6 See Keegan 1988, 18; Yamada 1979, 6789; Unschuld 1985, 67100; Sivin
1994.199;andLu1980,8990.

symptoms, and of how diagnoses andtherapeutic decisions areformed by
evaluatingthepatientinallthesecontexts.(1993,198)
ElisabethRochatdelaValle putsit differently:

TheSuwendealswithphysiology(particularlythestudyofthevisceraand
the pathways of qi), etiology (through the description of pathological
mechanisms),diagnosis(bypulseexaminationandothermethodsofinves
tigation), andtreatment(by acupuncture, moxibustion, phytotherapy, mas
sage,andexhortationtoaspirituallife).(1989,67)
Thesubtitle ofthe first volume of the Suwen Projectdescribes it in

termsofNature,Knowledge,Imagery,indicatingjusthowdiversethe
content is. In a 2004 lecture,moreover, Hermann Tessenow graded Su
wensubjectmattersintermsoftextualcontent:1)diagnosticsandprog
nosis; 2) therapy by needling; 3) pathology; and 4) hygiene and health
care.
All thesecontent descriptions and summaries are correct and rele
vant.Since it is amedicalbook, it isnotsurprisingthat thebulk ofthe
text is on diagnosis, prognosis, therapy, and pathology. However, the
importance of elements on nourishing life should not be overlooked.
Lifestyle, peoples relationship with nature, preventive medicine, and
sexualbehaviorare alltopicsthatrunlikeathreadthroughthetext.
In other words, the book is a multifaceted document with estab
lishedmedicaltheories, such asthe yinyangand fivephasesdoctrines,
atitsbase,relyingonanobjectifiedviewoftheworldwithnotracesof
personal search for higherlevel truth or understanding of immortality
likeDaoisttexts(Kohn1992;Engelhardt1998).Thoughthesumtotalof
thetextpertainingtolongevityandsexualmethodsissmallincompari
sontoits moremedicalparts,itisyetanimportantsourceonsexinearly
China.
The Suwen being the result of the grouping and regrouping of a
numberofshorterdocuments,someindependentofeachotherandoth
ers designed to explicate or attack earlier texts (Keegan 1988, 25254),
hasalongtraditionandtransmissionhistory.Itispossiblethatpartofits
knowledge existed before writing was established and was transmitted
orallyasindicatedintheLingshu,whereQiBosays:Thisiswhatteach
ersofthepastpassedontomethroughoralinstruction(28.1).Theex
tant Suwen, therefore, could have begun as snatches of oral history or
34 / Chapter Two
pieces of text written by numerous unknown authors who came from
variousmedicaltraditionsanddifferentlocalitiesandwhowroteatdif
ferenttimes.
The Suwen differs from other Han medical books because it is not
only about medical theories but interweaves medicine with concepts of
philosophy, physiology, lifestyle, and more. Others are more technical
textbooks, containing recipes and instructions. The questions in the Su
wenmay bebasicbutthey arecertainly not easy. Themultifacetedcon
tentandlaconicstyleoftheworkmakesitimpossibletounderstandits
meaning without reading its various commentaries, of which Wang
Bingsis the mostimportant.
The Wang Bing Edition

The oldest extant Suwen was reconstructed by Wang Bing (fl. 762) and
edited by Gao Baoheng et al. (11th c.). Wang Bing admits in his
prefacethat he collated and revised the textby rearranging the order,
rewritingthesentences,andaddingnewchapters.Untilanearlier copy
is unearthed, scholars assume that he added theQidalun (Seven
Comprehensive Discourses) on the theory of the five phases and six qi
(chs.6671,74), aboutathirdofthetext. GaoBaohengfurther suggests in
acommenttoWangBingsprefacethatthesediscoursesarethesameas
theComprehensive Discourses on Yinand Yangwhich Zhang Jilists
together with the Suwen, Jiujuan, and Nanjing (Classic of Difficult
Issues) intheprefaceofhisShanghan lun.
WangBingslaborresultedin 24scrollswith 81chapters,ofwhich
chapters72and 73 aremissingapparentlyalreadylacking inhismas
tercopy, the edition by Quan Yuanqi (see Duan 2001). His version
formed the basis of all subsequent editions. Even if one takes out the
chaptersassumedtohavebeenaddedbyWangBing,itisstillatextthat
hasbeen molestedbymanyscholarsor/andphysiciansfromdifferent
medical lineages and localities over more than 600 years. The received
edition thus contains many different explanations for the same phe
nomenon,contradictory theories, erroneous arrangements, different an
notations,aswellaspassagesthatmerge textandcommentary.
Hermann Tessenow points out examples of contradictory theories
as found in chapters 16.4 and 64.4 (2002, 656). Ma Kanwen notesmany

mistakescausedby omissions,erroneousarrangements,copying errors,
wrong annotations, and misunderstandings (1989, 1116). 7 These diffi
cultiesarefurthercompoundedbythefactthatWangBingmadequitea
few mistakes inhiscommentary. Gao Baohengandhiscoeditorspoint
outmistakesnot only in Wang Bings rearrangementof thechapters of
Quan Yuanqis edition,but also demonstratemany misunderstandings.
ThesecondhalfofthetextprobablyarosefromthelaterSuwencompila
tion(i.e.,betweenHanandTang)(Tessenow2002,648).Thus,theextant
Suwen text is now understood as a record of the process of discussion
and dispute, by which classical medical doctrines are formed (Keegan
1988,25254).
Little is known about Wang Bings life except from the Tangren
wuzhi (Record of Tang Personalities), which mentions that he
was an official with the rank of Minister Coachman (taipuling ).
TheWestern Han had apostcalledMinister of Husbandry(taipu ),
whowasresponsibleforthemaintenanceoftheimperialstables,horses,
carriages, and coach houses, as well as for the supply of horses to the
armed forces.8 This sounds like an unlikely post for a man of letters.
CatherineDespeuxsuggeststhatthetitlemaybeacorruptformofDivi
nationDirector(taibuling )(2001,43)abitmorelikelygiventhat
Wang Bing professes in his preface that he admired the Dao and was
partialtolongevitypracticesinhisyouth.Italsolendsweighttotheas
sumptionthatheaddedthesevenchapterswhichdealwiththedoctrine
ofthefivephasesandsixqiusedinexplainingtherelationshipthatan
cient Chinese observed between climate and a broad range of natural
phenomena,includinghealthandillness.
Wang Bing began to edit the Suwen in 751, using Quan Yuanqis
Suwen xunjie (Instructions and Explanation of the Suwen) from
about503ashismastercopy.Itisnotclearhowmanychaptersthisver
sionhad.NathanSivinnotesthatscroll7hadbeenlost,sothatthisver
sioncontainedonly8scrollsand68chapters(1993,202).PaulUnschuld,
on the other hand, maintains that Wang Bing restructured Quan
Yuanqiseditionof69discoursesin9scrollsintoavolumeof79chap
Heseesproblemsinchapters2.3,5.3,3.3.4,3.2.2,and43.5(1989,718).
See Wang 1949, 150151; 153154; de Crespigny 2007, 1223; Bielenstein
1980,3435.
7
8
36 / Chapter Two
tersin24scrolls(2003,46).However,therecentreconstructionbyDuan
Yishan,has70 chaptersin8 scrolls withscroll 7missing(2001,1).
Wang Bing finished compiling, editing, and writing his Suwen in
762. His monumental work includes over 500 passages of commentary
and citationsof 536passagesfrom38texts(Unschuld2003,4041).David
Keegan notes that, according to the textual tradition, Wang Bings ver
sionwasnotsimplyacompilation,butthelastina progressiveseriesof
compilations (1988, 254). He further emphasizes that none of the
Huangdineijingcompilationswehavetodayareidenticaltotextsknown
underthistitleintheHan.HermannTessenowsimilarlyconcludesfrom
his analysis of the texts structure, contents, and historical layers that
compilersusedthedialoguesasadevicetolinkoriginallyseparatetexts
together (2002, 64752). Akira Akahori adds:
Intheend,whentherearemorethan2000yearsbetweenthecompilationof
thetextandthepresent,therewillalwaysbeacertainamountofdistortion
duetolackofinformationregardingthesocialbackgroundthataffectedthe
formationoftheconcepts.(1989,19)
This may be true during the early compilation of the Suwen but
whenWangBingmadehiscopy,hewaswellawarethatideasandprac
tices of nourishing life made an important contribution to the develop
mentofmedicaltheories.Hethusmadesurethatthesetopicswerefac
tored dominantly into the welldeveloped and systematized medical
theories asfoundinhiscompilationoftheSuwen.
Chapter Three
The Longevity Connection
There is no mystery to the Dao of sex. All that is required is to
take time, feel comfortable, and place great emphasis on har
mony.
Ishinp
The Chinese language has a special term for dying young (yao ) as
opposedtopossessinglongevity(shou).ThecharactershouinZhou
bronzeinscriptionsisbyfarthemostpopularterminprayersforbless
ings (Y 1964, 87). But it is not dying young per se that the Chinese
dreadit is the fear of dying before fulfilling ones natural life
expectancy or heavengiven years (tiannian ). These years represent
thetimeallocatedbynaturethatpeople,animals,andplantsaretostay
onearth.Thus,theZhuangzimentionsthelifeexpectancyoftrees(ch.4).
Similarly,chapter54oftheLingshuisentitledTheHeavengivenYears:
ittalksabout howones bodyconstitutiondevelops,howtostayhealthy,
andwhattodoinordertoliveoutonesyears.
Theaspirationtoremainhealthy andattain long lifeprovided op
portunities for thediscoveryand developmentof theartsof nourishing
life.Theyincludevarioustechniquessuchashealingexercises(daoyin
), breathing exercises, massages, dietetics, and the bedchamber arts
(sexualcultivation).1
Theearliestmentionofthetermyangshengfornourishinglifeap
pearsintheheadingofZhuangzi 3:Yangshengzhu (TheImpor
tance ofNourishingLife). Zhuangzi 15has thefollowing:
1 For a survey, see Engelhardt 2000. For collections of articles on various
methods,seeSakade1988;Kohn1989;2006.Onhealingexercises,seeKohn2008;
ondietetics,seeEskildsen1998;Kohn2010a.
37
38 / Chapter Three
Tohuffandpuff,exhaleandinhale,blowouttheoldanddrawinthenew,
dothebearhangandthebirdstretch,interestedonlyinlonglifesuch
are theflavors ofthe practitioners ofhealing exercises,thenurturers ofthe
body,Pengzusripeoldagers.(Graham1981,265)
It appears that Zhuangzi was mocking those who just practiced

longevitytechniquesbutneglectedotheraspects,suchasselfcultivation
orinnerperfection.AparableinZhuangzi19illustrateshispoint.Ittells
the story of two men practicing selfcultivation. One cultivates his in
side,butheiseatenbyatigerfromtheoutside;theothercultivateshis
outside,butsuccumbstoafeverfromtheinside.Bothofthemforgot
to combine the twothey neglected to whip the lagging sheep as a
skillfulshepherdwould(Hertzer2009).Similarly,Lieziseesthequestfor
immortality notmerelyasfutilebutevenimmoral(Creel1956,151).
Though healing exercises, breath control, massages, and dietetics
are all part of nourishing life, this study deals especially with the bed
chamberartsinconjunctionwithhealthandmedicine.Itisimportantto
notethedifferencebetweennourishinglifeandperfectingindividual
life (quansheng ) as mentioned in the Lshi chunqiu. The latter is a
form of hedonism and favors indulgence, whereas the former is about
livinglonginmoderation(Y1964,8283;Stein1999,10,24).
Inthiscontext, the Suwen focuses on nourishing thebody (yang
shen ;25.3).TheYellowEmperorwantstoknowhowtodifferentiate
deficiency(xu)andexcess(shi).Inresponse,QiBolistsfivethingsa
physician shoulddobeforeapplyingacupuncture:1)cultivatehisspirit
(zhishen );2)nourish hisbody (yangshen);3)understandtoxicdrugs
(duyao );4) learnhowtouseastone blade(bianshi );and5) know
how to examine the blood and qi of the organs (fuzang xueqi ).
Thereisacleardifferenceherebetweentakingcareofthephysicalbody
(somatic)andnourishinglife(psychosomatic).
TheSuwen alsospecifiesthe importance of achievinglongevity. Qi
Boexplainshowthepeopleofhighantiquity didso:
The people of high antiquity knew the Dao:they [followed] the method of
yinyang, they [practiced] harmonizing the art of numbers, they observed
temperanceintheirfoodanddrink,theyroseandlivedwithregularity,and
they did not recklessly overstrain themselves [inclusive of sexual activity].
Hence,they were able to maintainand preservetheir body and spirit, and
The Longevity Connection / 39

theycouldliveouttheirheavengivenyears,reachingoverahundredyears
beforedeparting. (1.1)
Longevity can only be reached when one stays in good physical

health, and the Suwen indicates that the main objective of longevity
methodsistobringbalancetotheorganism.Thebodyisamicrocosmof
thegreateruniverse,andtheaimistostriveforthestatusofabalanced
person (pingren ), who is healthy both physically and psychologi
cally.2 TheSuwen describesbalanceintermsofyinandyang:
When yin is in excess,yang will be ill;when yang is in excess, yin will be
sick. An excess of yang brings about [pathological] heat; an excess of yin
bringsabout[pathological]cold.Extremecoldturnsinto[pathological]heat,
and extreme heat turns into [pathological] cold. [Pathological] cold harms
thebodyand[pathological]heatharms theqi.(5.2.4)
It alsoaddsthatabalancedperson is someone whoisnotsick.A

physician uses the pulse of a healthy person as a criterion to measure
thatofasickperson(18.1).Thewholechapterfocusesontechniquesto
examinethepulsetodeterminewhetherapersonishealthyorsick.
Wang Bings preface supports his conscious effort to connect lon
gevityideasandmedicaltheories.HeprofessesthatheadmirestheDao
andwaspartialtonourishing lifeinhis youth;he alsopushes thiscon
victionthroughhiscommentaryofthefirstfewchapters.MovingQuan
Yuanqischapters6162,2526,and63tothebeginning of thebook is a
clear indication of his belief that nourishing life is the foundation on
whichmedical theories arebuilt. It isquitepossible thathedidthis on
inspiration from the Taisu, which describes ways of long life and the
needtomatchthepatternsof natureinits first scroll.
Inanycase,WangBingnotesinhisprefacethathewantedtheSu
wen to be used as the source ofthe supreme Dao to nourish life, elimi
nate distress, keep proper qi complete, guide vital energy through the
body, raise awareness of how to live a long life, and recover from ail
ments. He ends with the hope that the Suwen will help to prevent the
emperorandhissubordinatesfromdyingbeforetheyliveouttheirallot
2 TheEnglishwordhealthhasnodirectmatchinearlyChina.Ahealthy
person is a pingrennormal, harmonious and balanced. The modern word for
health(jiankang )wasfirstcoinedinJapan(Sivin1987,95n1).
40 / Chapter Three
tedlifespanandtogivebothbarbariansandChinesetheopportunityto
prolongtheirs.
Another connection is with Daoist practice in the Tang, notably
formsofmeditationsuchasinnerobservation(neiguan )andsitting
in oblivion (zuowang; see Kohn 2010b) as well as with internal al
chemy (neidan ), which first developed at the time. The system in
volves esoteric doctrines and practices to transcend individual states of
being in favor of oneness with the Dao (see Robinet 1989, 30307; see
KohnandWang2009),makingusealsooflongevitytechniquesandves
sel theory. It underwent three main phases of development: 1) an em
bryonicphasebeforetheTang,2)earlyneidanintheTang,and3)ama
ture stage from the late Tang onward (Skar and Pregadio 2000, 465).
Basedonthis,Wang Bingflourished in theearlyneidanphase, which
mayhaveinfluencedhisdecisionto placegreateremphasisonlongevity
doctrines.
ThroughouttheSuwen,techniquesconnectingsex,health,medicine,
and longevity are prevalent.The text forms strands that allowlonglife
conceptstocrossoverintosystematizedmedical theories.Acloser look
atthefirstfivechapters(hereafterthe YangshengChapters)shows just
howWangBingusedthese doctrines.
Chapters on Nourishing Life

Thecompoundyangshengnourishing lifeappearsseveraltimes inthe
Suwen.First,inchapter2,thetermdoesnotindicatelongevitypractices
but denotes the way in which springqi affects the nourishment of the
germinating process. The corresponding phrases in the same passage
confirm this by mentioning the ways in which summerqi affects the
nourishment of the growing process; fallqi affects the nourishment of
theharvestingprocess;andwinterqiaffectsthenourishmentofthestor
ingprocess.Therefore, nourishinglifeinthispassageonly dealswitha
lesser part of the concept. In chapter 8, the term deals with longevity.
The passage advocates that anyone who follows all the rules correctly
willlivelong.Ontheotherhand,anyonewhoviolatesthe teachingswill
generate health calamities. In addition the Yangsheng Chapters sum
marizethe maintheoriesthathelpapersonachievelongevity.

Chapter 1, On Heavenly Integrity in High Antiquity (Shanggu
tianzhenlun ), starts witha discussion on how people in high
antiquity stayed healthy and lived long, followed by a presentation of
human physiology. It discusses human reproductive and aging proc
esses, and concludes by presenting four ideal personalities that can be
achievedbyfollowingnurturinglifetechniques.Theemphasisisonliv
ingacorrectlifestyle,suchasnottreatingalcohollikeanormalbeverage,
and not being reckless in daily lifewhich also means not having sex
whenintoxicated.Itstronglyemphasizeshealthcareandmoderationfor
attaining longevity. There is no mention of immortality or complex
medicaltheories.
Chapter2,TheGreatDiscourseonHarmonizingSpiritintheFour
[Seasonal]Qi(Siqidiaoshendalun ),dealswiththepreserva
tionofhealthinaccordancewiththefourseasons.Itchampionsthefact
that all those who live according to the law of yin and yang, adapting
theirlivestoseasonalchange,willachievelongevity.Itemphasizesthat
prevention of diseases is paramount to health and long life by offering
theoftquotedadvice:Oncediseasehasmanifesteditself,itistoolateto
seek a physician. It is like starting to dig a well when one is thirsty or
startingtoforgeweapons after warhasbrokenout (2.3).
Chapter 3, On Vitalizing Qi to Connect with Heaven (Shengqi
tongtian lun ), portrays the importance of nourishing life by
connecting with nature. It shows how the yinyang doctrine operates
within the microcosm of the human body and how macrocosmic ele
mentssuchasclimatechangecanaffecthealth.Itintroducesthefivefla
vors and connects them with a corresponding inner organ. Long life
rules here focus on food and harmonizing the five flavors: eating the
rightwaybynotindulginginanyoneflavorexcessively,livingsensibly
by keeping alcohol intake moderate and refraining from overexertion
during sexual intercourse. The chapter ends by stating that those who
followtheseprinciplescarefullyandobeythelawsofnaturewillextend
their lives and live out their heavengiven years. Throughout, it dis
cusses the yinyang doctrine in connection with health care but also
places great emphasis on living in harmony with nature and leading a
proper life.Thereare,asyet,no medicaltheories.
Chapter 4, On Perfect Words from the Golden Cabinet (Jingui
zhenyan lun ), is the first to discuss seasonal changes and cli
matefactorsthatcanaffecthealth.Itintroducesthenotionthatthebody
42 / Chapter Three
isdividedintoyinandyangsections(e.g.,thebackofthebodyisyang
andthefrontisyin).Itwidensthecorrelationofthefiveorganswithas
pectsof natureandwithinthebodytoincludeseasons, directions,colors,
sense organs, limbs, body fluids, smells, flavors, domestic animals,
grains, planets, musical tones, divination numbers, and forms of disor
der.Itpresentsnaturalphilosophy,suchastheyinyangtheoryandthe
correlationsbetweenmicrocosmandmacrocosm,bringingthemintothe
etiology of disease. However, medical theories proper have yet to be
formulated. Therelationshipbetween healthcare and nature is amajor
theme, yetideasofinternalmedicinebegintoemerge.
Chapter 5, The Great Discourse on the Manifestation of Yin and
Yang(Yinyangyingxiangdalun ),isthefirstchapterofBook
Two;itspeaksfromadifferentlevelofmedicalunderstanding.Itapplies
theyinyangdoctrinetoclassifynaturalphenomenaandexplainhuman
physiology, pathology, and diagnosis. It introduces the five excessive
emotions of joy, anger, sadness, worry, and fear as a cause of disease
(5.2.5)the first mention of psychosomatic factors. It also widens the
correlations of the previous chapter by adding climatic conditions and
human sounds (calling, laughing, singing, crying, sighing) which con
nect to the five bodily actions (grasping, grieving, spitting, coughing,
shivering) (5.3). Beyond presenting psychosomatic symptoms and sys
tematizingthemicromacrocosmicrelationshiponamorecomplexlevel,
it also names vessels and acumoxa points in conjunction with natural
philosophyand theetiologyof disease.
Thefivephases,asitdescribesthem,workinproductive(sheng )
andcontrol(ke )cycles,whicharestillappliedtodayinTCM.Thepro
ductive cycle represents a process in which the phases support and
maintaineachothersothatthebodycanstaybalanced.Thediagrambe
low summarizesboth, givingthematerialsymbolofthephaseplusthe
organsand viscera (seeFig.7).
Theproductivecyclecreatesanintegratedsystemofmutualsupport,
sustenance, and maintenance. For example, the kidney organ both sup
portsandiscontrolledinthefollowingway:
The north produces cold; cold produces water; water produces saltiness;
saltinessnourishesthekidney;kidneyproducesboneandmarrow;boneand
marrownourishtheliver.Thekidneyalsogovernstheears.(5.3)
Fig. 7.Thecyclesofthefivephases.
Thecontrolcycledescribesthewayhow differentaspectsmaykeepeach
other incheck.Forexample:
[Emotion] in the heart becomes fear; fear injures the kidney; worry over
comesfear.Coldinjurestheblood;drynessovercomescold. Saltinessinjures
theblood;sweetnessovercomessaltiness.(5.3)
Whenpathogenicfearinjuresthekidneyorgan,itisthuspossibleto
alleviatetheconditionbygeneratinga positivesenseofthevirtueassoci
atedwiththisorrelatedorgan.Similarly,whenexcessivecoldinjuresthe
blood,drynesscanbeusedtoovercomeit.Also,whenexcessivesaltiness
injurestheblood,sweetness mayremedyit.The controlcyclethusshows
the relation in which the phases in the natural world as well as in the
bodykeep eachotherincheckaspartofthenaturalprocessofbringing
equilibriumtothebody.Followingthesepatterns,onecanbecomea fully
balanced personhealthy bothphysicallyandpsychologically.
Thetwocycleshavetheirrootintheoriesofnourishinglife.Forex
ample, many recipes andmedicinal formulas in theMawangdui manu
scripts serve to restore balance in the person. They also bring together
natural philosophy and budding medical theories, providing the
groundworkforlatersystematizations.TheMawangduimanuals,more
over, reveal that sexual cultivation as a branch of longevity techniques
44 / Chapter Three
playsaroleintheemergingmedicalfaculty.MostofalltheYangsheng
Chapters show that practices of nourishing life formed an important
aspectofhealthinearlyChinaandthattheirpursuitcontributedgreatly
tothedevelopmentofmedicaltheories.
Daoistic Practices and Sexual Cultivation

The conceptofDaoandthe doctrineofyinyangruledtheChineseworld
in the Han, including the bedchamber. They were fashionable concepts
used to describe thecosmic andmetaphysical world.Heteronormative
sexbeingabinaryactionrequiringamemberoftheoppositesex,itoften
appearsasoneaspectofthedominantphilosophical,metaphysical,and
poeticexpressionofthe zeitgeist.
Thebedchamberartsare sometimes associatedwithDaoismbecause
oftheirrelationshipwiththeseconcepts.Isthereabasisforsuchanasso
ciation?ThevariouscategoriesoftextsintheMawangduicorpusindicate
that all threebedchamber arts, long life methods, and Daoistici.e.,
Daoiststylebutnotyetfully organizedactivitiesflourishedsideby side.
Howmuch,then,didthey influenceeachother?
Before we can answer these questions, it is important to look at
whatDaomeans in andbeforethe Han.Herlee Creelhasdiscussedthe
classicdebateonthemeaningofDaoismintheWarringStatesperiod;he
speaksofDaoismnotasaschoolbutasawholecongeriesofdoctrines
(1956,139).A.C.GrahamsimilarlynotesthatDaohasbothcosmological
andmoraldimensions(1989,105),whileDonaldHarperaddsthatDaois
part of the hygienic teachings (1998, 113). Livia Kohn sees Daoism as
multifaceted and insists that the veneration of the Daode jing and the
ZhuangzialonedoesnotmakeaDaoist(2001,41).HenriMasperoadds
that the Daodejing, Zhuangzi, andLiezi representonlyabranchoftheDao
School(inCreel1956,144).Inotherwords,whatmembersofthevarious
Daooriented groups at thetime did orthoughtis anexpression ofdif
ferentDaoistictraditions.Assuch,itisappropriatetospeakofasense
ofDaoisticendeavorstogive thesepracticesabroaderscopeandallow
ingfortheir allembracingnaturalistictendencies.
Nathan Sivin finds the word Daoist perplexing and points out
that dividing it into philosophical and religious branches fails to
match historicalreality anddoesnot improveour understanding(1995,

30330).AsHolmesWelchputsit,Daoistphilosophyandpracticeswere
embraced by a complex smorgasbord of adherents, who had taken im
mortality as their goal and could be alchemists, hygienists, magicians,
eclectics,and,inparticular,themembersoftheDaoistchurch(inSivin
1995,305).TheirsenseoftheDaoisticendeavorisnodoubtasvariedas
theirprofessionsortheirphilosophicalandreligiousbeliefs.
When the Suwenwas compiled, the Daoistic world was in no way
theorganizedreligionoflatercenturies.HenriMasperonotesthatinthe
4th and3rd centuriesBCE, Daoists were seekers for immortality,afact
which did not change much until the Later Han, when the first struc
turedcommunities emerged.3 Hecites SimaQiansportrait ofmembers
of the Daoist School (daojia ) as people who abstained from grain,
escapedoldage,andtransmutedcinnabartoattainimmortalitythrough
the three careers of good works, contemplation, and alchemy (1981,
42728).Obviouslytherearesome crossovers betweensexualcultivation
for nourishing life and the various Daoistic practices in the Han, but
theirgoalswerequitedifferent.Practitionersofyangshengstroveforlon
gevity whileDaoseekerspursuedimmortality(Kohn2001,4955).
Scholars often use Pengzu, said to have lived for 800 years begin
ningintheXiaDynasty(22nd17th c.BCE), 4 asevidencethatsexualculti
vationhas Daoist roots. They usuallycitetheSunjing, where thepro
tagonist explains to the Yellow Emperor how he can bring health, har
mony,andjoy intohis lifeandachieve immortality:
The Plain Woman said: There is a certain Splendid Maiden [Cain ]
who has received the wondrous [knowledge] of the arts of Dao. The king
senther toaskPengzuaboutextendingtheyearsandgaininglongevity.
Pengzu responded: By valuing essence, cultivating spirit, taking
[proper]food and herbal supplements, one canlive long. [But] if one does
notunderstandtheDaoofsexualintercourse[jiaojie ],theneventaking
lotsofherbsisofnouse.
The mutual fulfilment of man and woman is likethe mutual genera
tive [power] of heaven and earth. Because heaven and earth have attained
the Dao of union, there is unending limitless. When one loses the Dao of
3 OnthehistoryanddevelopmentofthemainmedievalDaoistschools,see
Bokenkamp1997,110;andKohn2001,8298.
4 ForadiscussionofPengzuinDaoismandmythology,seeSakade2007;on
hisroleinnourishinglife,seeCsikszentmihalyi2009,52932.
46 / Chapter Three
sexualintercourse,onegetsgraduallyclosertoearlydeath;ifoneisableto
avoid gradual injury [to life] and learn the art of yinyang [sexual inter
course], one practicesthe Daoof not dying.(seeWile 1992, 85;Hsia et al.
1986,2:152) 5
Pengzu is nodoubtthe paragon of longevity, associated with vari

ous techniques and especially with the Dao of sex. The earliest extant
sourcesthatmentionhimincludeWarringStatesbamboomanuscriptin
theShanghaiMuseum,themanuscriptsYinshu (ExerciseBook)and
Maishu (Vessel Book)fromZhangjiashan (see Kohn 2008; Lo 2010),
as well as the Shiwen in the Mawangdui corpusall from the southern
stateof Chu(Csikszentmihalyi2009, 529).
In the Shiwen, Pengzu teachesthatone shouldperfect onessexual
energy through healing exercises and breathing. In a similar way, the
YinshuspeaksofperfectingsexualenergyandidentifiesitastheWayof
Pengzu. These references suggest that Pengzu was seen from early on
asapractitionerofsexualtechniques,whichwerecloselyrelatedto heal
ing exercisesandbreathingandperformed inorder to examine longev
ity (Sakade2007, 791).Thisdescription is in accordance with Pengzus
roleastheancestoroflongevitytechniques.Butthatdoesnotmakehim
a Daoist, nor are his techniques specifically Daoist in the sense of the
latertradition.
By the Jin dynasty (265420), however, Pengzus sexual cultivation
techniqueshadassumedadifferentrole.ThisisdocumentedintheBao
puzi (BookoftheMasterWhoEmbracesSimplicity)bythescholar
andalchemistGeHong (283343).AsRobert Campanystates:
Pengzu was used as the mouth piece through which Ge Hong could com
mentat great lengthon these old techniques; and the gist of Ges com
ment is notso much to argue the benefits ofsexual arts(although he does
grant them) as to urge the unnaturalness of chastity as a cultivation disci
pline....[AssuchPengzu]becomesarepresentativeofbothpowerandthe
relativeshortcomingofcertainparticularcategoriesofpractice.(2002,183)
None of thebedchambertitles in the Hanshumention Pengzu as a

master oftheway ofthe yin.Maybethe Pengzucult lost favor in the
5 TheSunjingmaycontaintextsthatareconsideredtobedescendedfrom
theHanbutthisquoteistakenfromthe Ishinp,aTangtext.Similarly,somequo
tationsofthePengzujing arepreservedinChapter28oftheIshinp.

Later Han, indicatingalsoapossibleshift in Daoisticthinkingtowarda
position where the individual aims to diminish desires rather than use
sexual energy for cultivation (see also Eskildsen 1998). An example of
this appears also in the Hou Hanshu (History of the Later Han).
HereFanRui ,thefatherofFanZhun whodiedin93CEloved
the words of HuangLao anddevotedhimselftothepurification and
thediminutionofdesires(112562.3a).
Also,whilethebedchamberworksarelistedinaclassoftheirown
in the Hanshu, they appear in the medical section in the Sui and Tang
andonly show up under DaoismintheSong. Inother words, it took
over a thousand years for them to formally achieve Daoist status. By
then, of course, they had received varied influences from other tradi
tionsConfucianism,Mohism,Buddhismandhadbeenremadefroma
mostly healthoriented practice to one associated with religious and
spiritualquests.
Though Daoistic traditions and Daoist schools share many health
enhancingtechniqueswith longevityseekers,sexualcultivation forper
sonal transcendence was not an important practice in the Later Han.6
Early Daoist schools saw sexual cultivation only as a minor aspect of
their practice. 7 The vehement criticism of sexual cultivation in the
Xianger Commentary to the Daode jing by the third Celestial Master
ZhangLu (dat.215)confirmsthattheyeschewedsuchpractices(Bo
kenkamp1997,4445)whileyetusingritualizedintercoursetomaintain
theharmonyofyinandyanginthegreateruniverse.8
For a discussion of the bedchamber arts in relation to Daoism, see Kirk

land 2007, 40911; Strickmann 1974, 104445; Schipper 1993, 14455. For sexual
cultivation and sexual rites in Daoism after the Han, see Despeux 2000, 229;
Nickerson2000,27677;Maspero1981,51743;Liu2009.
7 Robinet states that the Maoshan exercises are performed in solitude, as
thetextsoftenpointout,withoutanyoneknowingaboutthem.Theyaretotally
internalandindividualpractices(1993,48).
8 Thesocalledheqi (harmonizationofqi)rite,asfaraswecantellfrom
briefnotesinlatersources,consistedofacomplexceremonyduringwhichmale
sexual energy (yellow qi) and female sexual energy (red qi) joined together in
accord with cosmic forces (Schipper 1984, 203). The rite was performed in the
quiet chamber (jingshi ), in the presence of a master and an instructor.Ad
eptsbeganwithslowformalmovementsaccompaniedbymeditationstocreatea
sacred space, then established the harmony between their qi and the cosmic qi
6
48 / Chapter Three
Asidefromthis,sexualcultivationmay have beenpracticedbymar
riedcouples,butunmarriedpractitionerswereencouragedtoliveasim
plelifeandreducedesires.Themajordifferencewasthatthebedcham
berarts weregearedtoahealthylifeonearth,whereas Daoist cultivation
focused on the practice as a means to immortality (Wile 1992, 2428;
Maspero1981,51743).
As the various concepts of health, spirit, religion, and medicine
movedfluidlybetweenthedifferentgroupsandfulfilleddifferentsocial
functions,ideasandpracticesinevitablyoverlapped.Thus,historicalre
cords reveal a cluster of overlapping ends coming from a common
metaphoricalormethodologicalstem(Csikszentmihalyi2009,529).But
thebedchamberartshaveultimately noDaoistroots.
Since the conceptual structures of selfcultivation regimens belong
tonoparticularschool,Daoorientatedtraditionsinfluencednotonlythe
socialstructurebutalsothetreatmentofdiseases,especiallyinlaterpe
riods (Strickmann 2002, 157). Daoist aspirations tend to be linked to
immortality buttheSuwendoesnotshowanysuchinfluence.Infact,itis
importanttonotethis fundamentaldifferencethattherearenomedical
texts which advocate thatpeople should strive for immortalityrather,
they consistently propagate prolonging life and not dying early. For
these goals, they recommended techniques that include sexual cultiva
tion.
Medical Theories
Chinese scholars, doctors, students, and practitioners of medicine have
alwayslookedbacktothepastandtoancientknowledgeforinspiration
and guidance. The Suwen is no exception. In the beginning, the Yellow
Emperor pointsoutthatpeopleinhighantiquitylivednotonlytoovera
hundredbutwerestillhappyandactive.Heasks:Whyisitthat people
nowadays live to fifty and are already weak and sickly? He wants to
knowifthisisduetothechangeintimes(environment)orwhetherpeo
through visualizations. The riteculminated insexual union and was conducted

amongnonmarriedcouples.SeeDespeux1990,2930;KohnandDespeux2003,
12;Raz2008.

plehavelosttheknowledgefromthepast,implyingthattheyshould
lookbackandlearnfromtheoldways.
Zhang Ji too, in the preface of the Shanghan lun, mentions that he
sought guidance from the ancients by consulting various classics
(Mitchell1999,29).Afterthat,almosteverymedicaltextmentionsusing
theancient worksas their sources. Even Wang Bingconfirms thisback
wardlooking tradition in his preface: he says that he hoped to clarify
mattersforstudentsbyquotingfromearlierworksandliststhirtyeight
textsashissources.
Therefore,totracethedevelopmentofmedicaltheories,itisimpor
tanttolookbacktolongevitydoctrinesandpractices.Theirprimaryem
phasis is on living in harmony with nature according to the seasons,
staying healthy by eatingthe right foods,preventingdisease with vari
oustechniques,andlivingouttheheavengiven years.TheMawangdui
manualsaccordinglyarewritingsthatsetoutthephilosophyandtech
niques for nurturing life (Lo 2001, 21). They served as key sources for
theSuwenphysicians,helpingthemtolookbacktoenhancetheirmedi
calknowledge.
An early document on nourishing life is the Yangshengfang
(Prescriptions for Nurturing Life), a silk manuscript specifically on this
topic.Itconsistsofseventyeightrecipesfornourishinglife,followedby
severalentriesrelatedtosexualcultivationandexercises.Recipesofaph
rodisiacsforbothmenandwomenaswellas curesofsexualdysfunction
appear inthe firsthalf. Later entriesrelateto sexualcultivation and in
clude references that match other texts of the same period, such as the
Shiwen, the He yinyang, and the Tianxia. The last section has a labeled
diagramoffemalegenitalia.Alltheseindicatethatanewkindofmedi
cine in its infancyamedicine related to correlative cosmology and its
theoriesofyinyang(Lo2002,20),wheresexformedpartofthelongev
ityandmedicalequation.
Thedifferencebetween longevitydoctrines andmedical theories is
that longevity theory is based on the observation and recording of a
phenomenological experience of ones own body, which reflects hu
manexperience,whereasmedicaltheorydescribesillnessesandcuresof
otherbodies(Lo2001,22).9 Qilaterbecameoneofthemostprominent
9 Theideathatlongevitytheoryoriginatedfromthesubjectiveexperienceof
onesownbodyisnotsodifficulttofathom,especiallyforpractitionersofthe
50 / Chapter Three
concepts ofmedicaldiscourse,referred to as the subjectively felt sensa
tioninthebody.10
HeZhiguoandVivienneLohavearguedconvincinglythatlongev
ity practices had a great influence on many aspects of early Chinese
medical theories (1996, 114; also Lo 2001, 29; Harper 1998, 32). Vessel
theorybeganinrelationshiptolongevitypracticesratherthanconnected
topathology or thetreatmentofdiseases. By extrapolation, sexual tech
niquesbecame an importantpart of longevitypractice.Thismeansthat
sexualcultivation, asadvocatedbytheMawangduimanuscripts,which
already accept that qi flows through essential structures in the body
(Wenwu1990,10:8286;Harper1998,7790),contributedtothedevelop
ment of early medical theories. Donald Harper states: Indeed, the
Mawangdui andZhangjiashanmedicalmanuscripts indicate that vessel
theory may have developed first in connection with hygienic theories,
and wasthenappliedtopathology(1998,68).
MedicaltheoriesintheHanwerenotunified:theMawangduitexts
speakofelevenvessels,whilethelacqueredfigurinefromMianyanghas
nineboth different from the later standard twelve (He and Lo 1996,
123). Vivienne Lo compares the anatomical terminology in the He yin
yang andTianxia andpoints outjusthow much the naming of the acu
moxapointsinthe Suwenowestoearlysexualcultivationliterature(2001,
variousmoderntechniques,suchastaijiquanorqigong.Whentheseexercises
areperformed correctly,adepts becomesensitivetoqiandareableto feeltheir
pathwaysfromtimetotime.Similarly,whenaneedleiscorrectlyinsertedintoan
acumoxapoint,oneusuallyfeelsatinglingsensation,numbness,oraslightelec
tricalcurrentthroughthebody.SeeHsu1999,5887.Anotherexampleisthehis
toryofthereconstructionofauricularacupuncture.Thistechniquefellintodis
useforcenturiesinChinauntiltheFrenchmanPaulNogierstumbledacrossitin
the 1950s and revived it. He was able to reconstruct the map of the acumoxa
pointsintheearbytrialanderror(2008).Theear(er)ismentionedintheSu
wen as the hearing organ (4.3). Erbi (blocked ears) in 3.2.2 and erguo
(auricle)appearin59.1.4;ermu(earsandeyes)isfoundin3.3.1,andincon
nection with etiology such as erlong (deafness) (10.4.1) and erming
(ringingintheears)(28.4).Theearsarerelatedtothekidney(4.3;5.3),butthere
isnotraceoftheeareverbeingusedintheSuwen fortreatingdiseases.
10 For the formation of qi theory, see Harper 1998, 78; Sivin 1997, 23742;
Porkert 1974, 16676; Unschuld 1985, 6773.Qi and jing are the most important
aspectofsexualcultivationbutqiismostlysubsumedinallprocesses.Foradis
cussionon qi insexualcultivation,seeLo2001,4146.

3346;seealso Ellis,WisemanandBoss1989). Douglas Wileaddsthatthe
medical corpus of the Mawangdui manuscripts has given us a first
glimpse into principles of Chinese sexual practices (1992, 19). He con
firmsthedevelopmentfromlongevitydoctrinestovesseltheorieswhen
henoticedthatsexual practicessharemanyterminologieswithmedicine,
though not necessarily borrowed but often seems to spring from a
commonmatrix(1992,23).
The close connection between longevity techniques and the Suwen
remainedintactwellintothe17th century.TheKokonyjroku
(RecordofAncientandCurrentLongevity[Techniques])bytheJapanese
physicianTakedaTsan (dat.1692)revealsthatasetoftwenty
four illustrations on healing exercises was said to have been first ap
pended to the Huangdi neijing suwen and later included in the medical
textbook Qianjin yaofang [Essential Recipes Worth Thousand A
Pieces ofGold, 7th c.], andfrom there intothe 11thcenturyDaoist ency
clopaediaYunjiqiqian [SevenSlipsfromaCloudySatchel](Sa
kade 1989, 13). Takeda included a set of fifteen illustrations of the Five
AnimalsFrolic(wuqinxi ),saidtogobacktotheLaterHanphysi
cian Hua Tuo (d. 208) (Sakade 1989, 140).11 The close association
betweenlongevitydoctrinesandvesseltheorythusledtothecontinued
activationoflongevitytechniquesinamedicalcontext.
11 Besides being credited with the development of the Five Animal Frolic
exercise,HuoTuoissaidto bethefirstpersontoperformsurgeryinChinausing
a medicinal alcohol known as cannabis boil powder (mafeisan ) as an
anesthesia. For a translation of Hua Tuos biography in the Sanguo zhi
(RecordoftheThreeKingdoms),seeDeWoskin 1983,14053.
Chapter Four
Pathological Diagnostics
The causes of the hundred diseases are dryness and dampness,
cold and heat, wind and rain, excessive sexual intercourse, un
bridled joy and anger, too much drink and food, and unsuitable
living environment.
Lingshu
The progression from health care regimens to theorybased medicine
occurred throughtheunderstandingofpathologicaldiagnostics.Beforea
personcanselfadministercures, orhealthprofessionalscantreatpeople,
they have to understand the cause and effect of disease and cure. The
Mawangdui manuscripts already base their theory on the penetrability
ofthevessels,i.e.,thebeliefthatthepersonishealthyifthevesselshave
freeflowwhileailmentsariseduetoobstructions.Thus,theeighthques
tion ofthe Shiwennotesthat whenblood and qiought tomove and yet
donotmove,thisiscalledthecalamityofblockage.
In the Suwen, vessel theory is the basis for a universal model of
illness, which explains illness as a dysfunction of the human organism
withinthesystemofvesselsandinternalorgans(Harper1998,69).Dis
easesmanifest themselves when there is an imbalance of yin and yang,
typicallycaused bypathologicalfactors.Thereisnomentionofacquiring
virtueor discussionof religiousconcepts.
Pathological Factors
TheSuwensystematizesanddividespathologicalfactorsintothreecate
gories: exterior, environmental, and interiori.e., changes in climate,
52
Pathological Diagnostics / 53
lifestyle choices, and emotionaltendencies.Asregardsclimatechanges,
thetextstates:
Whentheeightwinds[fromtheeightdirections]turninjurious,theycause
channelwind[jingfeng ]whichaffectsthefiveorganswhilepathological
wind[xiefeng]causesdisease[byinvadingthechannels].Thisiscalled
dominanceofthefourseasons:springsdominanceoversummer,latesum
mersoverwinter, summersoverfall,and fallsoverspring.(4.1)
Thisstatementfurthersupportsthetheorythatchangesinclimate condi
tions constitute an exterior pathological factor: The hundred diseases
arecausedbywind,cold,summerheat,damp,and dryness(74.5.1).
Climaticfactorsnotonlycausedirecthealthproblemsbuttheycan
also havedelayedeffects andmanifest insubsequent seasons:
Injuriescausedbycoldinwinterleadtowarm[orseasonalfebrile]disease.
Injuriescausedbywindinspringleadtoindigestionanddiarrhea.Injuries
causedbysummerheatinsummerleadtomalariain fall.Injuriescausedby
dampnessin fallleadtocoughsinwinter. (5.2.5)
Hanmedicaltheoristsingeneralconsiderwindasamajorcauseof
illness (Unschuld 2003, 18394; 1982). They see it as a pathogenic agent
thatentersthebodythroughtheskin.Suwenphysicianscautionthatthe
wind factor insexual intercoursecancausehealthproblems.They note
thatwhenwindtakesresidence[inthebody]andcreateslasciviousqi,
causingessence tobelost hence,whenoneusesstrongforce[insexual
intercourse],kidneyqiwillbeinjuredandthehighbonewillbespoiled
(3.3.2). Lascivious qi here means that one is given to excesses. Thus,
Chunyu Yi documents a specific case where frequently drinking alco
holicbeveragesandbeingexposedtostrongwindqimadeapersonill
(#24).
Thismovespathology into environmental factors.TheYangsheng
Chapters offerplentyofadviceonhowtostayhealthyandliveacorrect
lifestyle.Chapter12showshowdifferenttypesofenvironmentandlife
stylegiverisetodifferentkindsofdiseases.Asregardsspecific lifestyle
choices,QiBocautionsthatwhenonefailstopractice moderationineat
ing and drinking and does not live in a good setting, these factors will
becomethe rootof disease. Hefurther says that overeating will injure
stomachandintestines(43.4)whiledrinkingandeatingwithoutmod
54 / Chapter Four
eration oftencausediseases(40.1.1).Therefore, aphysicianmustques
tionthepatientabouthiseatinganddrinkinghabitsaswellasabouthis
or herlivingenvironmentinordertomakeadiagnosis (77.2).
Another passage warns against unsuitable working conditions.
Thosewhoseoccupationsrequirethemtobesoakedinwaterandthose
wholiveindampsurroundingswillbesubjectedtoattackbydampness,
whichcausesmuscles and fleshtobe limp. This leadstoblockagesand
numbness,whichinturndevelopsintoflaccidityofflesh (44.2).
QiBosummarizesthepathogenicfactorswhentheYellowEmperor
wantsto know the essentials ofwherefullnesscomes from and where
emptinessgoesto. Heexplainsthatyangrepresentstheexteriorandyin
theinterior,andthatthecauseofinjuriestoyinandyangiswaywardqi
orinjuries.Itcanaffect eitherone.Headds:
Whenadiseaseofyangiscontracted,itisduetowind,rain,cold,orsum
merheat.Whenadiseaseofyiniscontracted,itisdueto[intemperate]eat
inganddrinking,an[unsuitable]livingenvironment,[excessive]sexualac
tivity, or [extreme]joyandanger. (64.2)
TheSuwenalsostressesthatresidenceandenvironment,activities
andstillness,aswellascourageandtimidityofapersoncausechanges
in the pulse(21.1) and thus cause illness. Two passages in the Lingshu
linkclimate,emotions,andenvironmentwithsexualbehaviorascauses
ofdisease.Theyare:
Every [disease] is caused by wind, rain, cold, or heat; by yinyang [sexual
union], extreme joy and anger, food and drink, ones living environment,
greatfright,oroverwhelmingfear.(28.1)
As regardsthecause ofthe hundred diseases,they are duetodryness
and dampness, cold and heat, wind and rain, yinyang [sexual union], joy
andanger,drinkandfood, aswellasbyoneslivingenvironment.(44.1)
Climatechanges,livingorworkingenvironment,andlifestylehab
itsthus arefactorsthataffecthealth.Beingexterior,they canbemanaged
withphysicalsolutions,suchastakingcaretoprotectoneselffromheat
orcoldandmakingsurethatoneslivingandworkingenvironmentsare
conducive tohealth. However,the third kindofpathogenicfactors, the
interiorortheemotionalorpsychologicalkinds, areharder todealwith.
Chinesemedicinegenerallyconsidersthesevenemotions(qiqing
)asinteriorpathologicalfactors(Larre1996;Sivin1995,2:119).Arthur
Kleinman in this context has coined the term somatopsychics to de
scribe that disease and illness are bound up in psychological
physiologicalsocialinterrelationships(1987,7778).Thescholarphysic
ians of the Suwen are quite aware of psychosomatic concepts of health.
Theystressthatpeopleareabletoliveouttheirheavengivenyearsonly
if they maintain a balance in body and spirit (1.1): if body and spirit
havenomutual[connection], thisiscalleddeath(34.3).
The earliest interpretation of zhi as an emotional or psychological
stateappears in DuYus (d. 284)commentaryto the Zuozhuan.He
notesthatritesareperformedtocontrolthesixemotions[of]love,hate,
joy, anger, sadness, and happiness, and to see to it that they are never
expressedexcessively(Unschuld2003,22728).
However, the Suwen in its medical theory and correlation system
uses a set of five emotions: joy (xi ), anger (nu ), sadness (bei ),
worry (you ), and fear(kong ). It then explains their roles as patho
logicalfactors:
A person has five organs that [can]transformthe fiveqitoproduce [emo
tions]:joy,anger,sadness,worry,andfear. Joyandangerinjureqi; coldand
summer heat injure the body. Violent rage injures yin;sudden joy injures
yang.Recedingqimovesuptofillupthevesselsanddeformsthebody;in
temperateoutburstofjoyandangeraswellas excessivecoldandsummer
heatweaken theperson. (5.2.5)
This passage not only lists the five emotions as pathogenic factors
butalsolinksthem withclimaticchanges. Itnotesthat emotional states
arenotpathologicalaslongastheystayinbalancewiththeoverallnatu
ralandphysicalsystemandarekeptincheck throughtheconfigurations
of the five phases. They only harm the person when uncontrolled and
excessive. Therefore, violent emotional reactions, including those per
tainingtosexualmatters,leadtodisease:[Sexual]cravingsthatareun
bridledas well asendless worry and anxiety result in essentialqibeing
weakenedand destroyed (14.2).Italsosays:
Thinking without end, yearning forwhat cannot be obtained,anintention
thatoverflowsoutside,aswellasenteringthebedchamberexcessivelyall
these[cause]themusclesandtendonsto slackenandgetweak, sothatthey
becomeflaccid.Eventually,therewillbeawhiteoverflow.Accordingtothe
56 / Chapter Four
Xiajing [ Lower Classic], tendon flaccidity is caused by allowing [the
penis]inside[thewoman].(44.2)
Women, too, are cautioned to control their emotions, especially during

pregnancy inthesethreepassages:
Whenthereisexcessivesorrow,thecollateralnetworkvesseloftheuterusis
severed. When it is severed, yangqi will move internally. When that hap
pens,itwillcauseadownwardoverflow[ofblood]intheheart. (44.2)
Ifa[pregnant]womanfeelswretchedanddepressedandifcoldwindisat
itsutmostandpushesagainstopposing forces,theembryowilldie. (71.1.2)
Thediseasecalledfetalsickness[taibing]iscontractedwhen[thefetus]
isstillinthemotherswombandthemotherhasagreatfright[dajing].
Thiscausestheqitoascendwithoutdescending.Itwillstickwithessenceqi
andthechildwilldevelop peakillness. (47.1.9)
Althoughdesiresingeneralandsexual urges arenotincludedinthe

doctrineofthefiveemotions, theywereclearlyrecognizedaspathogenic
factors.Forexample,ChunyuYioncehadacasewhereayoungwoman
atthecourt of King Jibei sufferedfrom loinandbackpain.Hefound
thathermenseshadstoppedanddiagnoseditasaninnercoldcondi
tioncausedbydesiringamanbutunabletogetone.Heprescribedan
herbalformula,andhermenstruationresumed(Shiji105,#18).AsChen
Hsiufensays,thismaywellbethefirstdocumentedcaseofsexualfrus
trationinChinesehistory(2003,17172).
In another case, an ailment was caused by having sex while in a
stateofviolentanger(#6).Yetanothersituationarosewhenthepatient
engagedinintercourseafterexcessivealcoholintake(#1,7).Andinone
case the person got sick when he perspired profusely after sex and lay
prostrate on the bare ground to cool off (#9). In a few other cases, just
plainsexualintimacy(nei;jienei )causedthedisease(#3,10,23,25;
seeHsu2001b,70,87)
Thus,sexualintercourse,ifconductedwronglyorperformedinless
thancongenialcircumstances,canbeapathologicalfactorespeciallyif
inconjunctionwithexcessofsomekind,whichtheSuwenseesaslossof
control.Hanmedicalthinkingingeneralconsidersexcessivedesireasa
form ofpathology; the Suwen shows that itcontributes to disease. Bed
chamber adepts, too, note that it is useless to live a sensible life if one
doesnotknowtherulesofsexualintercourse.Themessageisthatlifeis
inperilifonehassexualintercoursewithoutproperunderstanding.Sex
ualmanuals,longevityclassics,andmedicaltextbooksfrequentlyrepeat
this message. Already the Tianxia states: What causes injury to life is
[ignoranceof]sex.Thatiswhy,whenthesageshavesexualintercourse,
theyhaverules:theyknowthe Dao ofsex.
Health Professionals
InthecourseoftheHandynasty, medicine transformedfromanarchaic
craft dominated by magicoreligious belief and practice into a theoreti
callygroundeddiscipline(Harper1998, 43).Including thevarious lev
els ofpractice, the Suwenaccordinglypresentsa healthcaresystemad
ministeredbyfourkindsofpractitioners:1)scholarphysicians(yi ),2)
skillmasters(fangshi ),3)shamans(wu ),and4)unskilledpractitio
ners(cugong).
Scholarphysiciansservedthecourtandthearistocracy.Theyprac
ticed their profession using a medical code based on formal theories,
which does not necessarily mean that their methods and theories were
unified. Theirtheoriesandmethodsformed thefoundationofthe Suwen.
Skillmasterswereversedinthetechniquesofmedicine,divination,
astrology,calendarcalculation,fortunetelling,weathermagic,exorcism,
longevity, healing exercises, breathing, sexual cultivation, and so on,
usually combining these with a talent in storytelling and political per
suasion (see DeWoskin 1983). Medical skill masters, unlike elite physi
cians,wereoftenassociatedwiththelowersocialstratabecauseoftheir
exorcisticandmediumisticpracticesperformed for thecommonpeople.
They are described as having different treatment methods and be
ing less qualified than the physicians. The Yellow Emperor highlights
this difference: Some of them regard the brain and marrow as [zang]
organs, whileand othersregard theintestinesand stomach[also] asin
ner organs. Yet others regard all of them as [fu] viscera (11.1). In the
contextofusingheattotreatcolddiseasesandviceversa,hefurthersays:
Skillmastersareunabletobreakthroughthatinkline[reachstandard
treatment skills] and cannot understand medical doctrine (74.5.4).
The third group of medical practitioners included the shamans,
sometimes known as shamanphysicians (wuyi ), also mentioned in
58 / Chapter Four
the Shiwen (#4). They used incantations (zhouyu ), sances, sorcery,
exorcism,numerology,andotheroccultpracticestohealthesick(Harper
1998, 14872). The Wushierbingfanghas a prescription thatcalls for the
invocationbyashaman woman (wufu )tosearchforachilddemon
(zhi ) presumably causing the illness (#50; Harper 1998, 302n1). The
Suwen,too,notesthatthe YellowEmperor heardofsuccessfultreatments
inantiquity.Atthattimepeoplelivedasimpleoutdoorlife,exercisedto
keepawaythecold,andstayedintheshadetoprotectthemselvesfrom
theheat.Theyhadnogreedanddidnotpursuefameorfortune.When
they were ill, they could be cured by moving essence with the help of
spiritinvocations(13.1).Shamans,too,contributedtothedevelopment
ofmedicaltheoriesintheHan(Creel1956,145;Harper1998,61n1),and
aslateastheMingdynasty,incantationswerebeingusedaspartofoffi
ciallysanctioned acupuncturetreatments(seeJackowicz2011). 1
The Lingshu confirms the understanding that the shamans had a
certain degree of medical knowledge at their disposal. In one passage,
the Yellow Emperor asks whether demons and sprites (guishen )
werecausingaparticularailment.QiBorespondswithawellgrounded
medical explanation and adds that,due to the subtlety of the ailments
manifestation, it appears as if demons and sprites were the cause. The
YellowEmperorfurtherasksifsomeonewhocaninvokethespiritscan
cure it.QiBoreplies:
In the old days shamans could [cure diseases] because they knew of the
dominanceofthehundreddiseases.First,theyneededtoknowwhencethe
diseasesarise,[then]theycouldinvoke[thespirits]tocureit. (58.2)
This shows that the shamans also possessed some medical knowl
edgeonthecauseandetiologyofdiseases.DonaldHarper hasidentified
fiftysixmagicalformulas intheMawangduimedicaltexts,nine ofwhich
callspecificallyforinvocations(1998,14959).
The last group of healers operating in the Han includes unskilled
practitioners.Astheirnamesuggests,theyarerough(cu)andwithout
formal training, i.e., without lineage or mentorprobably selftaught
and utilizing unrefined techniques. However, Lei Gong praises their
work in the Suwen, telling the Yellow Emperor that once he dared not
1 Today shaman healers are still active, even under the Communist gov
ernmentaswellasinoverseascommunities.See DeBernardi2006,90;Cline2008.
treat a patient because he was unsure of his diagnosis, but that an un
skilled practitioner used bloodletting. After the bleeding stopped, the
patientsbodyrelaxedandhewasmuchimproved (76.2).
Like other nonscholars, the unskilled practitioners are looked
downupon bythephysicians.TheSuwen says:
Whenanunskilled practitionertreatsadisease,herepeatedly insertsneedles
into yin and yang, resulting in disintegration of the body, convulsion of
thefourlimbsandimpendingdeath.Whenaphysiciandoesnotunderstand
[thepathologicalfactors]anddoesnotexaminethecausesandspeaks only
ofimpendingdeath,heiscalledanunskilledphysician. (77.2)
Whenthediseasehasalreadymanifested,theunskilledpractitionerdesires
to treat the exterior with fine needles and the interior with liquid concoc
tions. He adverselyusesattack[therapy].Asaresult, thediseaseisnotcured
andnewdiseasesarise. (13.2)
Hence, the Dayao[,Major Essentials]states: The unskilled practitioner
smilestohimselfasifheknows.Yet[before]heevenfinishestalkingofheat
or cold, the sickness has reappeared. He does not [know that] the same
[pathological]qicanhavedifferentforms.Heisconfusedbythesymptoms
andagitatesthechannels.(74.4.2)
Althoughthe Suwen doesnotmentiondiviners as healersas was

prevalentundertheShangandZhouitsworldwasstillcrowdedwith
traditionalbeliefsandaplethoraofallkindsofdoctors,healers,andma
gicians. Though it appears that scholarphysicians tended to dominate
themedical world with their theories andnewtherapies, theywere not
theonly playersand stillhadtodealwithbothpractitionersandpatients
preferringtheoldways:
Those who are possessed by demons or spritesone cannot talk to them
aboututmostvirtue.Thosewhodetestneedlesandstone[blades]onecan
nottalktothemaboututmostskill[in treatment].(11.0)
The four kinds of health practitioners thus served alongside each

other.TheSuwenmentionsskillmastersfourtimesandunskilledpracti
tionersfivetimes.Although itdoesnotexplicitlyspeakaboutshamans,
theirpractices appeartime and again. The Lingshuhas one referenceto
them.TheYellowEmperoraskshowitwasthatsomediseasescouldbe
60 / Chapter Four
curedbyincantations;QiBoanswersthatshamansofearliertimesknew
how to cure the hundred diseasesbecause they understood their cause
andeffectand thuscould cure themwithincantations(58.2).
AsDonaldHarperpointsout,thedevelopmentofmedicaltheories
is the result of the crossfertilization between medicine and other
branches of natural philosophy as well as various practical traditions
that involveskillmasters as well asshamans,drug gatherers,unskilled
practitioners, midwives, and wet nurses (1988, 44). Medical theories in
the Suwen,thus, aretheproductofsuchcrossfertilizations.
Diagnostics
Innovations in the medical field inevitably create controversies among
practitioners and scholars, which lead to changes in diagnostics, thera
pies, pharmacology, philosophy, andbody perceptions. As social back
ground, technological premises, and conventional knowledge undergo
their own changes over time, health practitioners have to review their
thinking.Thisalsoholdstruewithregardtodiagnosticandtherapeutic
methodsintheSuwen.
Techniquesandtherapiesusedtohealandtoalleviatepainareclear
responses to physical and psychological suffering. However, before
treatmentcantakeplace,ahealthpractitionerneedstohaveasystemto
organizethecollecteddataandworkoutstrategiesandtreatmentplans.
Thus,practitionersdevelopeddiagnosticprocessestogatherinformation,
then formulatedhypothesesandtheoriesonwhatwaswrongandwhat
shouldbest bedone.
PreSuwenmedicinedidnothaveasystematizedsystemofdiagno
sis. To practice medicine was synonymous with to practice recipes
(weifang ), a feature clearly represented in the Mawangdui corpus
(Harper 1998, 4554). As the Wushier bingfang indicates, medical tech
niques treated mainly external diseases such as wounds, bites, hemor
rhoids,burns, scabs, abscesses, andthe likeailments that needed little
analysis.Thehealingprocess was gearedmainly toward alleviatingthe
patientssufferingwithwhatever meansthepractitionerssawfit,includ
ingmechanical,herbal,andshamanictechniques.
In contrast, the Suwen shows a clear leap into formal diagnostics
andcontainsvarious rulesaphysicianshouldfollowduringanexamina
tion.Howdoesoneconductanexamination?thetextasks(20.2).An
swers vary: To treat a disease, one must seek out its rootcause (5.1).
Thebesttimetoexamineapatientisintheearlymorningbeforeyinqi
begins to move, before yangqi begins to disperse, and before he takes
foodand drink(17.1).
The most common diagnostic tool is the patients facial color or
complexion (se ). The Yellow Emperor states that a good physician
mustcheck thepulse and study thecomplexion of apatient in order to
diagnoseadisease(19.4.1).SimilarlyQiBosays:[Examiningthecondi
tionsof]thecomplexionandthepulseiswhat are mostimportantforthe
Highest Masters. These [techniques] have been handed down from the
early masters (13.2).2 Needless to say, while the practitioner observes
the complexion, he will also take note of the physical appearance, i.e.,
whetherthepatienthasastrongorweakconstitution,tendstobefator
thin,andsoon.Thephysicianpracticesthelookingpartofthediagno
sis(seeKaptchuk2000).
TheSuwen represents a stage indiagnosticswheretongue analysis
wasstillin itsinfancyor,beingmoreofanherbalpractice,notyetcon
nected with acupuncture. It speaks about thetonguewithin thesystem
ofcorrelations,notingthattheopeningassociatedwiththeheartisthe
tongue(5.3). Italsoincorporates it intotherapy,sothattheroot ofthe
tongue (sheben ) plays an important role in acupuncture as well as
the origin of vessels (22.3.2; Lingshu 21.2).And it does have some rudi
mentarytongueobservation:
A patient with febrile disease of the lungs experiences first chills, then his
bodyhairstandsup[goosebumps].Nexthehasaversionto windandcold,
thetipofhistongueturnsyellow,andhisbodybecomesfeverish.(32.1)
Observing the complexion might be the most common of diag

nostic tools but the most important is palpation (mai ) of the pulse,
bodyandchannels. Maiisalsothegeneraltermtodenoteallvessels,i.e.,
theprimarychannels(jing ) andthe secondarycollaterals(luo ). Su
wen physicians use pulse diagnosis to determine its movements and
quality within yinyang parameters. For example: The pulse can be
2 Similar statements also appear in chs. 13, 15, 17, 19, 42, and 44. Se as
complexionisfoundin10.1,16.5,36.2,74.2.1,74.2.5,81.2,and10.2.
62 / Chapter Four
weak, strong, slippery, choppy, floating, or sunken. This can be distin
guished by thefingers(10.4.2;seealso 13.2,17.1,77.2, and 5.1).
Thethirdmodeofdiagnosisofinquiryappearsinthetextuallayer
of chapters7581,addedintheTang.Chapter77givesadetailed analysis
onhowaphysicianshouldproceedwithhisexaminationwithoutmak
ingthefivemostcommonmistakesindiagnosis. Itsays:
Hehastoquestionthepatient[abouthislife],whetherhewaspossiblyno
bleinthepastbutisnowhumble,abouthiseatinganddrinkinghabits,his
living environment, ifhe is experiencingsudden happinessorsudden sad
ness,ifhemaybeexperienceshappinessfirstandthensadness....Indiag
nosis, one must know the endand [how it began],and have knowledge of
alltheextrasigns[symptoms].Theuseofthepulse[diagnosis]andinquiry
shouldbeappliedaccordinglyto both menandwomen.(77.2)
Thistextuallayeraddsinquiryasadiagnostictoolandappliesgen
derdifferentiation.Forexample,a physicianshouldbeabletodetermine
by palpation whether a pregnant woman is about to give birth. Qi Bo
says that a clear sign that a woman is pregnant is when her body has
sickness but no injurious pulse [movement] (40.1.6). Also: When the
Shaoyin Vessel of the foot in a woman pulsates violently, she is with
child(18.3.6).
ThefourdiagnosticmethodsusedinChinesemedicineofobserva
tion, palpation, inquiry, and hearing/smelling also make use of sexual
factors.Thus,aphysiciancansee aswollen genitalduring examination
or the patient may inform him that hehas pain in the genitalia area or
thathecannothaveanerection.Similarly,intreatingapatient,thephy
sician may ask about his or her sex life or examine the genitals. Any
pathogenic odor or discharge from the sexual organs will no doubt be
noticed.Pulsemovementcanindicatesexualorgynecologicalproblems,
suchasthetwocasesrelated topregnancy.
After the Suwen was compiled, many earlier methods began to
wane.QiBolamentsthatinhistime,whentreatingapatient,physicians
werealreadyneglectingtheimportanceofobservingthecomplexionand
pulsediagnosis(13.2).AccordingtotheSuwen,regardlessoforiginsand
lineage,itisonlyafteraphysicianhaslearnthowtodoaproperdiagno
sis that he canselecttheappropriatemethodoftreatment.
Treatment Methods
Suwenphysicianshaveclearandpragmaticviewsondiseasesandnever
tire of emphasizing the importance of staying healthy. They prefer to
catchunhealthytendenciesbeforetheygrowintoillness,butonceadis
ease has manifested, theyhave various methods of treatment (5.1). The
useoftheneedleisforemostamongthem,buttheyalsodiscussthepros
andconsofothertechniques.
Different geographical regions developed their own brands of
medicine, 3 so that physicians from various areas used different treat
ments.QiBomentionssixwiththeirrespectiveregionsoforigin:1)lanc
ingstones (bianshi)fromtheeast;2)toxicdrugs(duyao)fromthe
west; 3) cauterization or moxibustion (jiuruo ) from the north; 4)
nineneedle therapy (jiuzhen ) using fine needles(weizhen ) from
thesouth;5)stretchingandpulling(daoyin )fromthecentralplains;
and 6) pressingandlifting (anqiao) fromthecentralregion(12.1).
Lancingstonesoriginatedintheeastandwereusedtotreat carbun
cles and ulcers orboils (yong /yang ) (12.1). Most scholars translate
bianshi as pointed stone or stone needle,but I am more inclined to
think ofit as abladelike instrumentmade of stone used for lancing or
scraping. The mere insertion of a pointed stonedoes notcause profuse
bleeding, and the text suggests that patients receiving such treatment
were lanced or surgically cut. Ge Hong similarly notes that even Pan
Kongshu(ca.470380BCE),asemilegendaryengineerofLuandpatron
saint of mechanics, could not make sharp needles out of shreds and
stones. . .The gods and spiritscannotmake possiblewhat isreally im
possible; heaven and earth themselves cannot do what cannot be
done (Lu 1980, 71). This suggests that the instrument was not as
pointedasaneedlebut morelikeastone blade.
Thereisalsoanotherinstrumentknownasthechiseledstone(chan
shi ). The Suwen says: They must administer toxic drugs to attack
[pathogenics]intheinterior,anduse a chiseledstone,a needle[acupunc
ture],andmugwort[moxibustion]totreattheexterior(4.1).Itispossi
3 Even as lateasthe 19th century, new medicaltraditions were invented in
thesouthofChina.SeeHanson2001,26291.
64 / Chapter Four
blethatthechiseledstoneisanothernameorvariantofthestoneblade.
QiBomentionsitoncemore,sayingthatoneshouldnotuseachiseled
stone inthetreatmentofapregnantwomantoavoidinjuring her (47.1).
The next method mentioned is toxic drugs. They appear eleven
times in conjunction with treatments. However, hints on the use of
pharmaceuticalsappearin26ofthe79discourses(Unschuld2003,285).
Thetextrecommendstoxicdrugsforobesity(zhifei)(12.2).Theysig
nifyadistinctlymedicaltreatment,usedtoaffectcure foranacutecondi
tionasopposedtodietarytherapywhichstraddlestherealmbetween
longevityandmedicine(Kohn2010,5068).Plantsusedtotreatdiseases
usually containsomeleveloftoxicity, whilethose usedfordietarypur
poses or as supplements are mostly nontoxic (wudu ) (see Engel
hardtandHempen1997).
Theonlypharmacologicaltherapyrelatedtosexisinthecontextof
curing dryness of blood (xueku ) caused by having lost a large
amountofbloodwhenyoungandengaginginsexual activity whileinan
intoxicated state, which exhauststheqiand injuresthe liver. This isthe
reason thatmenstruation will decline orstop(40.1.2).Theprescription
is not only for curing the medical problem but also involves restoring
male potency: it contains black cuttlefish bones, madder root, sparrow
eggs, andabalone. 4
Thirdly,cauterizationormoxibustioncamefromthenorthandare
usedtotreatabdominalproblems.VivienneLonotes that the Tianxiahas
theearliestevidenceofatraditionofmoxibustionassociatedwithpre
ventive and restorative, rather than curative medicine (2005, 244). By
thetimetheSuwenwascompiled,moxibustionalone(28.1,34.2.1,60.3.2)
or moxibustion and needling (jiuci ) (19.2.3, 24.3, etc.) have became
importantmethodsfor treating allsortsofdiseases.
Nineneedle therapy, fourth on the list, is the application of nine
kindsofneedles to differentpartsofthebody:
The first kind of needle isto insert intotheskin;thesecond,intotheflesh;
thethird,into thevessels;thefourth,into thetendons;thefifth,to thebones;
Sparrow translates que , glossed in the Shuowenjiezi as small bird.
The identification as sparrow goes back to Li Shizhens (15181593) Bencao
gangmu(Li1994,257175).Abalonetranslatesbaoyu,whichUnschuldren
derscarp(2003,297).Itreallyisabaloneandalsoknownasfuyuorshijue
ming .SeeLuo2003,1217;Read1977,524,#222.
4
thesixth,toregulateyinandyang[qi];theseventh,toincreaseessence;the
eighth,toexpel[pathogenic]wind;andtheninth,tomakethenineorifices
penetrable. (54.4;seealso Lingshu 1)
Thepractice originated in thesouth and also uses fine needles, es

pecially for cramps and blockages (12.1.4). The Suwen states that fine
needlesaregoodforcuringexternalillnesses,whiledecoctionsarebetter
forinternaldiseases(13.2).Ifasmallobstructionspreadseverywhere,it
willfollowthevesseltocome;[inthiscase]fineneedlesarebest,likein
commonpricking treatment (58.2.2). GweiDjen Lu suggests these fine
needlesmayhavebeenusedforacupunctureintheZhoudynasty(1980,
6977), but this is unlikely since needle techniques and acumoxa points
are not mentioned in the Mawangdui manuscripts and they probably
developed after the 2nd century BCE. When the Suwen was compiled,
physicians were alreadyusing fineneedles for treatmentwhich were
notmadeofstone.
Nineneedle therapy was already on its way out when the Suwen
wascomposed.QiBosaysthatwhenoneknowstheoriginofthethree
partsandninesubpartsofthepulse,itisunnecessarytoretaintheuse
ofthenineneedlediscourse(26.3).Sinceacupunctureisthemainther
apyin theSuwen, it ispossible thatnineneedle therapy followed a dif
ferent theoretical model. Hence, it was considered not worth retaining
the theorybutits toolscontinuedtobeused.
Healingexercises,lit.guidingandstretching,isthenextmethod
listed. They originated from the central region and were used to treat
flaccidityorrecession ofmuscles as well asdampheat syndromes.The
Suwen describes them as being used in treating chronic fullness of the
lower flank and the tendency toward reverse qi flow (47.1.2). Similarly
thesixthmethod,massagesorpressingandlifting, camefromthe cen
tralplainsandwasusedtotreatsimilarconditions(12.2).Itshouldnot,
however, be used in the winter to avoid getting nasal stuffiness and
bleeding norfor diseasesoftheneckandnapeinthe spring(4.1).
Natural phytotherapy, shamanic practices, incantations, sances,
rituals, sorcery, exorcism, numerology, and other occult practices are
furtherbutlessertreatmenttechniquesintheSuwen.Thetextoftentries
to convincethosewhofearneedlesandbladestobelieveintheirefficacy,
making lightofthemore supernatural dimension ofdisease. For exam
66 / Chapter Four
ple:TheDao[ofmedicine]hasnodemonsorsprites.Treatmentalways
followsthesameprinciple:itcomesaloneanddepartsalone (25.3).
Anothermethodisbloodandqiletting.Althoughmentionedonly
in passing, it may have been quite common (12.1). As Paul Unschuld
says,itissafetostatethatbloodlettingoccupiesahighlyvisibleifnot
prominentpositionintheSuwen.Altogethertwelvetreatisesreferexplic
itly to the practice of bloodletting (2003, 268). This may be true but
thereareotherpassagesthatrefernotonlytopurgingofbloodbutalso
ofqi.Forexample,Whenthereisasurplusofqi,purgethe passageways
of [patients] channels, without causing injury to the channels, loss of
blood,orleakageof qi (62.2.2).
The Suwen physicians seemed to have moved away from these
methodsandconcentratedmoreonneedletherapybasedonvesselthe
ory. Their treatments moved from the realm of spirits and magic to a
more theorybased medical world. However, before vessel theory was
completely established, during the transitional phaseand also in later
periodshealing exercises andmassageswere still usedparallelto ves
seltechniques(12.1.5).Thesemethods,moreover,formanessentialpart
of classical longevity techniques and have continued to play a role as
supplementaryandpreventativemedicalmethodstothepresentday.
Although Suwen scholars did not specifically mention sexual prac
ticesasamethodoftreatment,thetextmakesserverreferencestothem,
notablydiscussingthesevenwaysofdiminishingandeightprocedures
ofincreasing[qi] (qisunbayi )doctrine(5.4.2).Thisindicatesthat
in all probability, sexual methods were accepted for improving health.
SumiyoUmekawaarguesthatinlatertextssuchastheXuannjingand
the Yufangmijue, sexual positioning was important for women to reach
orgasm so that they could generate essence for men to absorb which
would strengthen their bodies and improve their health (2005, 911).
How,then,did theearly Chineseconductsexualencounters?
Chapter Five
Speaking of Sex
Although full of desire, do not act in haste. Kiss, embrace, and
employ the art of foreplay.
He Yinyang
Threewordsmostcommonlyexpresssexualandotherformsofdesirein
ancient and early China: se (sensuality, pleasure, lust), yu (desire,
craving),andhao (liking,fondness).Allthreeareconnectedtosexual
ityandexpressdifferentwaysofworkingwiththesexualdrives.
To begin, se is considered one of the oldest characters associated
with sex. It appearsinvarious uses.Thus,intheMengzi (Mencius)
Gaozisays:[Theloveof]foodandsexis partofhumannature(IVA.1).
SimilarlyConfuciussays:Ihavenotseen[anyone]wholovesvirtueas
much as he is fond of sex (Lunyu 9.17); and: A gentleman has three
[things]toguardagainst...Inhisyouth,whenhisbloodandqiarenot
yet stable, he should thus guard against sex (16.7). The Zhuangzi has:
Thatwhichassistslifeisfood andthatwhichinjureslifeis sex(ch.12).
Se can simply be translated as sex, but that does not convey its
historical,social, andculturalsenses. Thecontexts inwhichthe wordis
usedconveydifferentdegreesofsexualconnotation.IntheMengzi,itis
notonlysexorlust,butincludesthefinerdetailsofsexualallurementin
femininity,beauty,andwomenasanobjectofdesire.Itispuresensual
ity,thequestforsensorypleasure, aninstinctornaturalimpulselikethe
needforfoodanddrink.IntheconversationbetweenMenciusandGaozi,
secanjustaseasilyberenderedasgluttony,pleasure,fun,lust,
generally indicating somethingpeoplegoafterthatlendsitself to excess.
Se in the Lunyu encompasses all that is represented in the Mengzi,
butinadditionthetextusesthetermastheoppositeofvirtue,makingit
almost derogatory. In the second passage, it represents a cautionary
67
68 / Chapter Five
noteawarningtoyoungpeoplenottogiveintothetemptationsofsex
and sensuality. TheZhuangzi,finally, usesthe wordinthesenseof lust
but contrasts it with food, which gives life while indulgence in various
pleasuresandsensorygratifications takesitaway.
Se as an innatedesire inhumanbeings, then,formspart ofhuman
nature, yet it has all sorts of negative connotations, especially so when
used in association with women. The Lien zhuan affirms this: it treats
physicalbeautyandtheexpression of femininity indress andcomport
ment withsuspicion and frequentlylinks femininebeautyand allureto
immoralityanddangertomen(OHara1978,186214).
IntheMawangduicorpus,seappearsintheShiwenandTianxia,the
formerusingitinthemoreinnocuoussenseofcolor.Thelatter,how
ever,usesitwitha sexualconnotationand paraphrasesthe Zhuangzi:
Whenapersonisborn,therearetwothingsthatneednotbelearnt.Thefirst
is breathing and the second eating. Except for these two, there is nothing
that is not the result of learning or habit. Hence, that which assists life is
foodandthatwhichinjuresitisse[sex].Thatiswhy,whenthesagesengage
intheunificationofmanandwoman[sexualintercourse],theyfollowdis
tinctrules.
In the Suwen, se appears in four different meanings. The first is

color,e.g.,heavenandmountainsareofonecolor (71.2.2);thecolor
of the urine has changed (74.2.2); and the urines color is red (45.1).
Second it forms part of the compound wuse (five colors), matching the
fivephases(5.3).Third,itreferstocomplexion,describedasanessen
tial diagnostic tool, and last it occurs in the compound sese and
meansagitated (49.5).
Wang Bings commentary has the word in the sense of sex, ex
plainingthe idea ofdesire(yu):Takingpleasure in sexiscalled lust;
using ones essence lightly is called dissipation; when there is no tem
peranceinsexualpleasure,essencewillbeexhausted(1.1).Eventoday
the tendency is to use the word with negative sexual connotations, for
example, selang (sex wolf) is a lecherous man and seqing (sex
stimulation)ispornography.Inthemedicaltexts,ontheotherhand,its
senseofsexandsensualitygraduallydiminished,andthewordtendsto
beusedforcolororcomplexionas adiagnostictool.
Desireisadifferentstory.TheLijiuses itwithclearsexualconno
tations:Thegreatdesiresofhumanbeings aredrinking[alcohol], eating
Speaking of Sex / 69
[good food], andmating [male and female] (ch. 19).The Lshichunqiu
categorizes it as an emotion and uses it to emphasize moderation:
Heavengavebirthtohumanbeingsandallowedthemtodevelopava
riceanddesires.Desirescomeasemotions,andemotionscanbemoder
ated. Thesagecultivatesmoderation to stop desires;hencehedoesnot
overly expresshisemotions.
The Suwenusesthe wordyu for desire eightyseven seven times
singly and four times in the compound shiyu or craving. Here it
signifies a powerful emotion that requires a response and includes a
widespectrumoffeelings.Forthemostpart,itjustmeanswishingtodo
something,butonoccasionithassexualconnotations.Desireisanin
natefeeling, mostlyassociatedwithsimplewishes,forexample,thewish
toknowsomething(yuzhi)(3.2.1).Italsoappearsaspartoftheetiol
ogy of disease, such as the urge to vomit (yuqu ) (33.1). Other ap
pearances include loss of appetite or not wanting to eat and drink
(buyushiyin )(38.2.1),a hankeringforcolddrinks(heyulengyin
)(35.1), and being fondoftalking (yuyanyu )(16.3).
Inonepassageitclearlymeanslust:Usingdesire[lust]toexhaust
ones essence (yiyu ke qijing ) (1.1). In another, it is craving:
Unbridled craving, endless worry and fear result in essential qi being
weakenedanddestroyed(14.2).GuoAichunexplainsthatthismeans
that essential qidiminishes.Uncontrolleddesireof any kindisbad for
healthandsexualdesirewithoutlimitwillexhaustessence,leadingto
anoverall decline.
Haoisthethird termof thegroup.Itcanbetranslatedasliking or
fondnessandsignifiesalesserpowerthanseoryu,asinbeingfondof
beauty/sex/women (haose) in theLunyu passagecitedabove.The Suwen
hasthetermthreetimes,usingittodescribesymptomsofdiseasesrather
thanemotionalstatesorsexualdesires.Forexample,haoming means
being fond of sleep (32.29), haodaxi means liking to breathe
deeply (38.1), and haowo quxi is being fond of sleeping with
oneskneesfolded(45.2).
However,theLingshumentionsthephrasehaoyan (fondofcol
ors)inconnectionwiththe characteristicsofpeoplewhodonotlivelong
anddieviolentlybecausetheyarefondofbeauty,sex,andwomen,and
tendtobe hasty bynature(64.1.3).Therefore,inthiscontext,thetermis
liketheloveofbeauty,sex,andwomen.Thetermlove (ai)isused
onceintheSuwenbutwithoutsexualconnotation:Ifthatwhichisloved
70 / Chapter Five
is the exterior; this correspondent to summer qi and this is the Dao of
nourishment andgrowth(2.1).
Tosum up, theSuwen seessexual desire as anormalemotionpro
vided it issomewhatcontrolled.Only when excessive,turning into lust
orcraving, willitharmthebodybyexhausting essenceorruiningqi.
SexTalk
Sexual desire leads to sexual encounters, which the Chinese describe
withalanguage bothpoeticandfullofvividimagery.Thus,intheWest,
whenthemanliesontopofawomanwespeakofthemissionaryposi
tion (Rusbridger 1986, 9399). When a Chinese man lies on top of a
woman, it is silkworms tenderly entwined (can chanmian ),
swallows hearts united (yan tongxin ), or dragons all curled
up(longwanzhuan ).Thereareatleastsevenvariationstothisba
sicposition,aslistedinDongxuanzisThirtyMethods[ofIntercourse]
(Hsiaetal.1986,18183). Otherpositions,suchasthosedescribedinthe
Sue pian, also have poetic names, such as Couching tiger and curling
dragon and Reversepiercingofthehibiscus(seeFigs.8,9).
Chineseerotictermsconjureupjoy,nature,romance,freedom,fun,
mystery,excitement,andhumor.TambanoYasuyori,theJapanesecom
pilerofthemedicaltextbookIshinp,thoughtitamusingenoughthathe
commented on the expression phoenix holding a baby chick (feng
jangji ) meaning a large, fat woman having intercourse with a
smallman(Hsiaetal.1986,181,#16).TheHe yinyang and Tianxia listten
basic sexual positions as roving tiger, cicada clinging, measuring
worm, river deer butting, locust splayed, gibbon grabbing,
toad, rabbitbolting, dragonfly, andfishgobbling.
Sexexpressedasanaturalhumandesireplaysanimportantrolein
ancient Chinese culture, as is documented variously in preHan writ
ings.1 The erotic content in some of these texts is illustrated by the rich
andvividimageryofcopulation,sexualsymbolism,andprosedepicting
carnaldesire,sexualyearning,andthejoyofsex,plusmenandwomen
havingamorousencounters.
1 SeeMiddendorf 2007,20619; Goldin 2002,147; Riegel1997;Harbsmeier
1995;andBischoff1985.
Fig.8:Couchingtigerandcurlingdragon.Suepian,no.26.
Fig.9:Reversepiercingofthehibiscus. Suepian,no.31.
72 / Chapter Five
Even the hexagrams in the Yijing, showing the creation of the
world and the four seasons, connect to reproduction and fertility as
manifestedinhumansexuality.Astronomicalandpoliticalideasaswell
as male and female organs are associated with thefirst two hexagrams
Qian (heaven) and Kun (earth) andtheir coming togethercorre
sponds to the sexual act (Schilling 2009, 34344). According to early in
terpretations,Hexagrams63,AfterCompletion(jiji ),and64,Be
fore Completion(weiji ),connectto womensmonthlycycles (2009,
744,748).
Van Gulik, too, sees hexagram 63 as a symbol of sexual union,
which expresses the perfect harmony of man and woman completing
eachother,graphicallydepictedbytheperfectalterationofyinandyang
lines.Toachievethisharmonywasconsideredthebasisofahappyand
healthysexlife(1961,3738;alsoWilhelm1950,24448,70914;Schilling
2009,74345). He cametothisconclusionbecausetheuppertrigramKan
symbolizeswaterandthelowertrigramLisymbolizesfire,whichcorre
spondtowomanandman.Thishexagramisalsocommonlyusedtoex
presssuchaunion ininternalalchemy.Hexagram64similarlyplaysan
importantroleinlaterlongevityandsexualtechniques.Itstextinstructs
men how not to lose semen: the young fox should not get his tail wet
whencrossingtheriver.
The Great Appendix of the Yijingstresses that intercourse of com
plementary forces is the foundation of all life and the manifestation of
the cosmic forces of yin and yang (Schilling 2009, 20910, 77980). The
second part of the Commentary states that when heaven and earth
[provide] the generative forces, the myriad things transform and take
shape; whenmale and femaleblend their jing; themyriad things trans
form and are brought forth. The expression male and female blend
theiressence(nanngoujing )appearsinWangBingscommen
tary (1.3): That which gives life is called essence; [when the] two es
sences[ofmaleandfemale]unite,whatresultsiscalledspirit(1.3).He
believes that what produces life has its origin in essence and when the
essence ofamanandawomanintermingle,anewspirit,anewindivid
ual,isconceived.Manandwomanistheexpressionusedforsexinthe
Liji:Drink,food,andsexarepeoplesgreatestdesires(ch.19)TheSu
wen, on the other hand, uses the term conventionally as man and
woman or maleandfemale(5.3,77.2).
SexualvocabularybeforetheHanwasstillsetmostlyinthesphere
ofphilosophicalexpression, butas bedchambervocabularydeveloped,it
moved into the more concrete and objective. The bedchamber arts are
known byterms used alsofor sexual intercourse: inside thebedcham
ber(fangzhong),asubcategoryofsexualtextsinthe Hanshu;wayofthe
yin(yindao), found inthe titlesof sixbooks;artsinside thebedcham
ber(fangzhongshu)andthewayofbeingintimate sexually(jieyinzhi
dao ), used inthe Shiwen(#3); theinnerchamber(neifang )
as in abooktitle in theHanshu;andbedchamberaffairs(fangshi )
(Li andMcMahon 1992,145; Van Gulik 1961, 70).Insidethebedcham
berisbyfarthemost common.
Sometermsappearinvariationsbut,onthewhole,thelanguagein
theSuwenismoreclinicalthanthatofMawangduiandearliertexts.In
the Han, inside thebedchamberhas become an acceptedpart of lon
gevity culture and is of clear importance in health maintenance and
medicine.Therewasnoneedforfurtherembellishmentorexplanationin
conjunctionwithsex.2
Foreplay
The human sexual act and peoples sexual responses have not changed
much in the last five thousand years. Ulrike Middendorf summarizes
LuriaandRoses fourstagesinthehumansexualresponseasfollows:
Firstly,excitement(erectionofthepenisanddilation,lubricationoftheva
gina); secondly, plateau (continuation of physiological and psychological
changes initiated during excitement, adding some new ones); thirdly, or
gasm (occurrence of a clearcut set of contractions in both sexes, with dif
fused psychological changes) and lastly, resolution (reversal of the physio
logicalandpsychologicaleventsstimulatedbythearousalstate).(2007,85)
Inthissetting,theaimofforeplay(xidao )istoachievearousal
forbothpartiesbefore engaging in intromission.According toMidden
2 For a complete glossary of sexual terms and euphemisms based on
Bishops Songs of the Orchid Tower, the Mawangdui manuscripts, Gerhard
Schmitts Sprche der Wandlungen, the Shiji, and Wen Yiduos Shijing de xingyu
guanyi,seeMiddendorf2007,21124.
74 / Chapter Five
dorf,sexualarousalinthemaleandfemalemaybeeitherreflexogenic,
by direct physical stimulation, or psychogenic stimulation, resulting
from erotic imagery or reading and viewing eroticabooks, paintings,
decorations and so forth (2007, 85). More specifically, reflexogenic
stimulationincludescaressing(caodun ),kissing(xiangwen ),and
embracing (xiangbao ), all found in the Mawangdui manuals.3 Psy
chogenic stimulation is borne out by Zhang Hengs Tongsheng ge,
where the new bride locks the doors of the nuptial bedchamber, then
sheds her robes, removes her makeup and hair ornaments, and rolls
out the picture scroll next to the pillows (Middendorf 2007, 85; Van
Gulik1961,73,77).
The Tianxia describes erection as a threestage process. When the
penisisstimulatedandthereisnotumescence,itmeansthatthefleshis
notready; whenthere is tumescencebutno firmness, itmeansthatthe
musclesarenotready;whenitisfirmbutnothot,itmeansthattheqiis
notready.Ifoneengagesinintercoursebeforethefleshisready,thepe
nis willcollapse;before theqiisready,thepenisretreats.TheSunjing
referstoasimilarprocessinfourstages,detailingthatthepenismustbe
properly aroused before intromission. The same also appears in the
Ishinp (ch.10; Hsiaetal.1986,175;seealsoWagner1981,10).
TheTianxiafurtherstipulatesthatitisimperativeforthepenis tobe
properlyaroused.Thefourthamongtheeightproceduresofincreasing
[qi] (bayi ) is knowing therighttiming.Thismeans thatforeplay
should be properly conducted before using the penis to enter the
woman.Usingthepeniswhenitisnotreadyorunwillingwillimpair
qiandleadtoprematureaging,disease,andevenearlydeath.However,
whenthepenisisreadytoperform,thesexualactmovesintothesecond
stage:penetrationorintromission.
3 SeeLiLingandMcMahon1992,16768.TheHeyinyangalsogivesagood
descriptiononhowforeplayisconducted(MaJX1992,97783).
Intromission
Terms for intromission arecomplex: theycan be specific and rather di
rect, such as ru, to enter, or nei, to penetrate; but they can also be
metaphorical,using yin and yangto expressthe union, or euphemistic,
suchasyinqu,hiddentwists.
In the Mawangdui manuals, the most common term for joining by
penetrationisunitingyinandyang(heyinyang ),whichalsoap
pearsasatitle.Thecontentsleave nodoubtthatthetermrefersto sexual
intercourse. On the other hand, the Tianxia uses uniting man and
woman (he nann ) to express the sexual act. These expressions
arebothphilosophicalaswellaspractical,buttheyareclearaboutwhat
theymean.
Neither of these are found in the Suwen. It uses harmonizing qi
(heqi ),atermthatalsoreferstothecosmological,sexualritesofthe
early Celestial Masters. Both theYangshengfang and the Shiwen use the
term to denote sexual intercourse, the latter alsomentioning it without
sexualconnotationorreligiousovertones.Heavenandearthharmonize
theirqi(tiandiheqi ),itsays,speakingoftheunionoftheatmos
pheric qi of heaven and earth in a rather general cosmological manner
(25.2,25.3,74.2.1).Italsosaysthatinthehuman[body],theharmoniz
ing of yin and yang qi corresponds to the [six musical] tones (54.4)
againwithnorelationtosexualactivity.
The Shiwenusestheexpressionbeingintimatewithyin( jieyin)
to describe sexual intercourse (Harper 1998, 389n1). Contact with or
receivingyinisaninterestingexpressionbecauseofitsagriculturalas
sociations.RodoPfistercompares thesexual actto the agricultureproc
essofgrafting,inwhichlivingtissueisimplantedtoachieveanorganic
union. He seestheanalogy ofamantakinghisstalk to graft it intoa
womansslit.Theexchangeofsapduringthebiologicalprocessislik
enedtothe exchange ofqiand intermixing of essencein sexualcultiva
tion (2011, I3.6.1).Theconnection isnot surprisingsinceancient China
was an agrarian society.Ontheotherhand,bodyintimacy(jiexing
),anothercommonterm, clearlydenotessexualintercourse,bothinthe
Heyinyang and the Tianxia.
76 / Chapter Five
TheYangshengfangandWushierbingfanghaveanother expression:
approaching the inner [chamber](jinnei ). This may be related to
the earlier term approaching the womanschamber (jinnshi ),
foundintheZuozhuan (Zhao1)inreferencetosexualactivity.TheYang
shengfanginadditionhasthesimplewordengageordo(wei )as
an idiomatic expression of sexual intercourse(Harper 1998, 342; Li and
McMahon1992,167).
The Heyinyangusestoenter(ru )andexhortsmalepractitioners
to enter the mysterious gate (ru xuanmen ) and ride the coital
tendon(yujiaojin )togenerateqi.Thetextgoesontosaythatthe
coitaltendonisthesameasthecoitalvesselwithinthemysterious
gate(vagina).UlrikeMiddendorfseesruasaeuphemismforthemo
tion during sexual intercourse (2007, 91). In addition, the Yinshu uses
thephraseenteringthechamber(rugong )inthiscontext,whichis
closetotheexpressionmostcommonlyusedintheSuwen:enteringthe
bedchamber (rufang).The Yinshu has:
Falldays:Batheandwashthehairfrequently.Asregardsfoodanddrink,let
hunger or satiation be whatever the body desires. Enter the chamber how
ever often the body finds it beneficial and comfortablethis is the way to
greatestbenefit.
Winter days:Batheand washthe hair frequently. The handsshould be
cold and the feet warm; the face cold and the body warm. Rise from sleep
late;whilelyingdown,stretchoutstraight.Enterthechamberbetweeneve
ningandearlymidnight[11p.m.].Morewouldharmtheqi.(Wenwu1990/10:
82; Lo2001,26; Harper1998,11011)
In the Shiwen (#5), Shun uses the term shi , to allow, let, or
send,todenotesexualintercoursewhenhedescribedthenatureofthe
penis. Another expression is to allow penetration or to let [the penis]
inside [thevagina]orto let[oneself] into the inner[chamber] (shinei
);itdescribesasexualmaneuverwiththemaleintotalcontrolalso
foundintheSuwen(44.2, 10.2.4).
BoththeTianxiaandtheYangshengfanghavetheworduse(yong
) in the sense that the man uses his penis to penetrate the woman
(Yangshengfang; Harper 1998, 336). Both the Suwen (45.1, 70.3) and the
Lingshu(65.2.1;13.1.12)employthetermtoindicatesexualintercourseas
much as another term common in theMawangdui manuscripts: go to
bed (wo ) (also Suwen 10.4.2, 23.1.12). Harper translates itashaving
sexual intercourse in a passage of the Yangshengfang: When going to
bed(wo),wipethemaleorganandthefemaleorgan(1998,343n2).The
Shiwen (#4) also implies that going to bed means sexual intercourse
(Middendorf2007,90).
Another explicit term that appears only in the Shiwen and is not
found in any other Han text is penis encounter (shiyu ). Shi is an
acceptedterm forthemale organ (Harper 1998, 389n3),andthecontext
leavesnodoubt ofits sexualintention.
All in all, the Mawangdui manuscripts have a rich vocabulary for
sexual intercourse of which only three terms are retained in the Suwen.
Thisshows that sexual vocabularynot onlychangedovertimebutalso
that there was a gradual move toward simplification and standardiza
tion.The limitation in expressionmay alsobeduetothedivergentem
phasisofthetexts, i.e., themovefromsexualmanualstomedicalworks.
Climax
The Chinese sexual classics place little emphasis on the importance of
what wecallorgasm.TheMawangduimanuals describe theconclusion
ofthesexualactforbothmanandwomanasreversingaseriesofreac
tions initiated by penetration, but there is no big bang. Even though
themanualswerewrittenforandby men,theytooknoteonhowwomen
adjusted to the physiological and psychological changes at the conclu
sionofthesexualact(Pfister2011,I:3.5.27).Anadeptofsexualcultiva
tionshouldalwaysmakesurethatthewomanisarousedproperly,feels
pleasured,andreachesherlimitorconclusionbecausethatiswhen
shewillproducetheessenceheseekstoabsorb(Umekawa2003,9).
The He yinyang describes the conclusion of the sexual act as the
woman reachingherlimit(zu ),which issignaledbythe following:
Thenosesweats,thelipsarewhite,thehandsandfeettwitch,andthe
buttocks do not adhere to the bedmat, but rise up and away. The
Tianxia describes womans conclusion as reaching completion and be
having as if she had died. This description can be compared to the
physiologicalchangesduringfemaleorgasmasnotedbyWesternsci
entists (Kinsey 1953, 61323; Masters and Johnson 1966, 12834; Lloyd
2005;Luria and Rose1979, 168). However,it is still onlya highpoint
andnot necessarily the goal.The wordlimitappearsthirtyonetimes
78 / Chapter Five
in the Suwen without sexual connotation in the sense of complete or
sudden.Themedicaltextbookthusdoesnotgointodetailsofthesex
ualactor refertoitsculmination.
Thefinaleforthemanishardertoascertain.TheShiwen,initsfifth
andfinalexercise,statesthatthemanhastolethisgatheredessenceas
cend and absorb great illumination. After reaching this, he should stop
sothatessenceandspiritgrowmoreblissfuleveryday.Itdoesnotmen
tion ejaculationororgasm.However,the sixthoftheeightprocedures
ofincreasing[qi]intheTianxiateachesthatthemanafterwithdrawing
shouldallowsomeonetomakethepeniserectagain.Byarousingand
lettingitsubsideagainoneamassesqi.Whenitistimetoconcludethe
session,heshouldobservealltherulesonabsorbingthewomansqi.He
mustnotmove hisspinewhendoingsobutshouldpresstheabsorbedqi
andcalmhisbody to awaitthebenefit.Aftercompleteconclusion [and
withdrawal], the penis is washed (sa ). If it becomes aroused again,
pacifying and resting it is called stabilizing the tipping point. Again,
thereisnoexplicitreferencetoorgasmorejaculation.
The Yangsheng fang refers to the conclusion of the sexual act as
end(jiyi ; yi ).Laterliterature,suchastheIshinp,usesletgo
(shi ) to refer to ejaculation (ch. 28). The Suwen mentions that at age
sixteen,aboyskidneyqiisabundant,hisessentialqioverflows,andhe
candischarge(xie )orejaculate.Whenheunitesyinandyang,hecan
fatherchildren.Thus,thereisacleardistinctionbetweensextoenhance
health when there must be no ejaculation and to produce offspring
whenejaculationis required.
In the end, it seems, sexual cultivation as presented in the
Mawangdui manuscripts has primarily to do with enhancing essence
duetotheobviouslossofpreciousbodyfluidessencebeingmosttan
gibleinsemen.Theprimaryaimofthepracticeistoabsorbthewomens
qi,sothatadeptscanreplacetheirlossbyaprocesslaterknown asre
vertingessencetoreplenishthebrain(huanjingbunao ),thereby
enhancing health and long life. In addition, as later texts suggest, they
receive joy and satisfaction (kuai ). While theMawangdui manu
scriptsarenotmuchconcernedwiththisdimension,theSuwenusesthis
termonceinthecompoundyukuai inthesenseofsexualpleasure
(5.4.2).Inaddition,itcontainsahostofdetailedexpressionsanddescrip
tionsof sexualinteraction.
Chapter Six
Expressions of Sexual Interaction
The Yellow Emperor asked: How can I tell if a woman is ex
periencing pleasure? The Plain Woman replied: There are five
signs, five desires, and ten movements by which you can observe
her transformation and understand her reactions.
Sun jing
Expressions of sexual interaction in the Suwen take a variety of forms
and appear in a number of different major categories. Some are quite
concrete and speak about entering and penetrating; others are more
cosmologicaland metaphorical,invokingthecosmicforcesyinandyang.
Yet others talk aboutbasicphysicalbehavior, such asusing,doing, and
sleeping.Inaddition,therearesomeexpressionsthatimplythephysical
effortandpotentialenergydrainofsexualactivity;andafewwhichare
concernedspecificallywithmedicalconditionsandthepossibilityofde
velopingsymptomsordiseases.
Entering In
Themostcommon,leastcontroversialtermtodenotesexualintercourse
in the Suwen is entering the chamber (rufang ), not found in
MawangduioranyotherHantext.Itoccurs fivetimes:
Peopletodaydonot[liveinaccordancewith]nature:theydrinkalcohollike
broth, they employ recklessness regularly [in all activities], they enter the
chamberinanintoxicatedstate,theyallowtheirlusttoexhausttheiressence,
and they let their wastefulness dissipate their true [qi]. Hence, they barely
makeitto reach a half hundred[years]andareweakanddissipated. (1.1)
79
80 / Chapter Six
Thediseaseiscalleddrynessoftheblood.Itiscontractedatayoungage,
whenonehaslostalargeamountofbloodorhasentered thechamberwhile
intoxicated. The qi is exhausted and the liver injured. Thus, her monthly
flowdeclinesor staysout. (40.1.2)
Drinkingalcoholicbeveragesandbeingstruckby[injurious]wind,onewill
sufferfromtheleakingwind[syndrome].Enteringthechamber,sweating,
andbeingstruckby[injurious]wind,onewillsufferfromtheendogenous
wind[syndrome]. (42.1.2)
Whendeliberationandthinkingarewithout limit,whenoneyearnsforthe
unreachable,andwhenthoughtsareexcessiveanddirectedoutward,enter
ing the chamber excessively will causethe ancestraltendon toslacken and
develop flaccidity. Eventually, this will cause [emission] of white outflow.
Hence,theXiajingstates:tendonflaccidityiscausedbyallowing[thepenis]
inside[thewoman].(44.2)
Ifoneisfrequentlyintoxicatedandsatiated,thenentersthechamber,qiwill
gatherinsidethespleenandcannotdisperse.(45.1)
The commentaries on various passages indicate that entering the

chamber denotes sexual intercourse. This is further supported by pas
sagesfromthe Lingshu:
If one is intoxicated and enters the chamber, then perspires and is hit by
[injurious]wind,thespleenwillbeinjuredIfoneentersthechamberex
cessively, perspires, and then bathes in water, the kidney will be injured.
(4.1.1)
Entering the chamber while intoxicated, perspiring and being hit by wind
will injure spleen. Using forceto overexertionandthen entering thecham
ber,perspiring andtakingabath [inwater],thekidneywillbeinjured.(66.4)
Rufang, it becomes clear, is not genderspecific. It is a clear and simple

term,freefromanyembellishmentormysteryquitefittingforuseina
medicalbook.
Thetermneifang (innerchamber),ontheotherhand,appearsin
abooktitlelistedintheHanshuunderbedchamberarts:Prescriptions
from the Inner Chamber for Begetting Progeny of the Three Schools
(30.1778).Sinceallthebooksinthissubcategorydealwiththebedcham
Expressions of Sex ual Interaction / 81

berarts, herecalledthewayofyin,itcanbeconcludedthat neifanghas
the samemeaningasrufang.
Theword nei, innerorenter, appearsinseveralcombinations
with sexualconnotations,but by itselfrarely appearsinthe Suwen, and
inonly one passagemayhintat sex:
Thewestisaregionofmetalandjade;anareaofsandandstones... Its
people[eat]richfoodandgrowfat.Hence,injurious[factors]cannotin
juretheirconstitution.Theirdiseasesdevelop from within. (12.1.2)
Wang Bing comments that [diseases developing from] within

meansthattheycomefromindulginginexcessive joy,rage, sadness,fear,
drinking, eating, and sex. In other words, the Suwenuse of nei can be
interpretedto include sexual activity. However, theMingcommentator
MaShi(1998),theQingphysicianZhangZhicong(2002),andtheschol
ars from theShandongand Hebeimedical schools (1995)commentthat
neiinthiscontextreferstothesevenemotionsplustheingestionoffood
anddrink.GaoShishiequatesittojustthefiveemotions(2001).
Aconcreteuseofneitoindicatesexualactivitycanbefoundinthe
Lingshu,whichhas:Immediatelyafterpenetration[sex], thereshouldbe
noneedling [acupuncture]. Immediately afterneedling, thereshouldbe
nopenetration[sex](9.6.2).
Avariant ofsimple neiis shinei , literallycausing to enter or
sendingin.ItappearsfirstintheTianxiainthephrase:jishineibuneng
dao chanbing . Douglas Wile reads this to mean: When
thediseasemanifestswithin,itcannotbecontrolled(1992,80).Donald
Harperrenders itas:Ifhehas intercourse impulsively, he is unableto
affectthepassage(ofvapor[=qi])andbecomesill,andexplainsthatshi
nei is similar to jinnei , approaching the inner [chamber], which
refers to sexual intercourse in the Yangsheng fang (Harper 1998, 429n1,
339n4).RodoPfistertranslatesthesentenceas:Whorushestosend[the
penis]inside cannotcontroltheqiflow andthat creates healthdisorders
(2003, 46).Hermann Tessenow andPaulUnschuld, finally, defineshinei
astosendinward,i.e., havesexualintercourse (2007,38384)
Iwouldaddanotherdimension.W.Dobsondescribesshiasanaux
iliaryorcausativeverb,whichstandsbetween thecause andtheacting
agent. He calls it ergative in the sense of make or cause and per
missivein thesenseof alloworlet(1973,67172). Based on this, I
translate shinei as to allow in/inside or to let [the penis] inside [the
82 / Chapter Six
vagina] or to allow or to let [oneself] into the inner [chamber]. This
givesasenseofresponsibilitytotheman,whoshouldhavecontrolofhis
actionsas sexualcultivation demands.Thismakessense inthepassage
cited above, which notes that tendon flaccidity is caused by allowing
the penis inside(44.2). Wang Bing comments that shinei refers to the
physical exhaustion of yinpower and the exhaustion of ones essential
qi.Thisindicatesthatthetermisrelatedtosexualactivityandcanlead
to energetic exhaustion. Zhang Zhicong adds that nei means entering
thechamber,i.e., sexualintercourse.
AnotherpassageintheSuwen clearlyuses shinei tomeansex:
[When]thewhitevesselarrives,itspulsefeels rapidandfloating,depleted
aboveandin excessbelow.Ifoneisfrightened, therewillbeaccumulationof
qiinthechest.When[thepulse]israpidanddepleted,wespeakoflungob
structionwithalternatecoldandhot[spells].Thisconditioniscontractedby
allowing[thepenis]inside[thevagina]whileintoxicated. (10.4.2)
Thisimpliesthatlettingthepenisenterwhileintoxicatedisthecauseof
lungblockage.Anotherrelatedtermisjienei , intimacywiththein
side[ofthevagina/chamber],found bothintheShiwenand Lingshu.The
latterhas:Recedingqi..residinginthehidden organ [penis], one will
dreamofcontactwiththeinside[ofthevagina](43.3).Dreamingofsex
hereisconsideredabodilypathology(ChenHF2003,152).Theentire
chapterisonhowexcessiveqiinducesvariouskindsofdreams,linking
dreamstothemovementof qiwithvesseltheory.Thus,whenpathogenic
qidwellsinthegenitals,onewilldreamofsex.Thesexualact hereis part
ofthediagnosis,etiology,andpathologyofdisease.
Nei, therefore, is an expression that needs little imagination when
associated with sex. As a noun it conjures up the inner world of the
womenspatial,anatomicalandemotionalalludingtotheinnerquar
tersortheinsideofsexualorgans,oftencomparedtodarkplacessuchas
cavesorholes.Asaverb,itdescribesthefunctionofthepenisasatool
underitsownerscontrol,usedasaninstrumenttopenetratethevagina.
Bothusesoftheworddemonstrateintimacyspatialaswellasphysical.
Whenneiisusedinacompound,suchasshineiandjienei,itisboth
genderspecificandlocationspecific,denotingtheinteriorofthefemale
sexualorganortheinnerchamber.Itgivesthepowerandresponsibility
tothemeninthesensethattheycancontroltheiractions,i.e.,whetherto
enter into the inner quarters or not. Even after they have gone into the

chamber, they still have the power to decide whether to let their penis
enter the vagina. The use of shinei implies not only the control of men
over health but also over the household. Confucian ethics confer abso
lute power on men to control their women, which meansthat theycan
bestow or withholdsexualfavorsastheydesire. This power,especially
ofgranting sexual favors tonumerouswivesandconcubines,ifexercised
withouttheDao ofsex, caneasily leadtohealthproblems.
Yin and Yang

Ren Yingqiusconcordancelists234 entriesforyinyangin theSuwen
andLingshu(1986), while ADictionaryoftheHuangdiNeijingSuwenpro
videseightdifferentdefinitions,threeofwhichhavetodowithsex:yin
yang denoting the different sexes of man and woman, thebedchamber
arts, and the male and female sexual organs (Tessenow and Unschuld
2008).OnceintheSuwenandtwiceintheLingshu,theexpressionexplic
itly denotes sexualactivity.Forexample, the Suwenhas:
Now,injuriousnesseithermanifestsintheyinortheyang.Whenitmanifests
in the yang, it is contracted through wind, rain, cold, and [summer] heat.
When it manifests in the yin, it is contracted through food and drink, yin
yang[sexualintercourse],aswellasjoyandanger. (62.4)
The Lingshu supports this reading:

Allconditionsarecausedbywind,rain,coldandheat,yinyang[sexualin
tercourse], joy and anger, food and drink, living environment, great fright
andsuddenfear.(28.1)
Now, that which causesthe beginning ofthe hundred diseases is definitely
causedbydrynessandwetness,coldandheat,windandrain,yinandyang
[sexual intercourse], joy and anger, food and drink, as well as ones living
environment.(44.1)
TheIshinpis another source that uses yinyang todescribesexual

matters: it speaks of the way of yinyang, the affairs of yinyang,
theexchangeofyinyang, and theartofyinyang(28.63334).
Inallthesepassages,yinyangaswellasjoyandangerrefertotwo
differentactions,i.e.,thephysical as insexual intercourse andthe emo
84 / Chapter Six
tional as in worry and fear. Given that human behavior plays such an
importantpartinthelongevitydoctrine,thethreereferencestoyinyang
canbetakenaspartofarecurringsocialmotifofanoverindulgentlife
style dominated by food, drink, luxurious homes, and sexual excess,
whichultimatelylead todiseases.
A variant of the simple yinyang is harmonize yinyang (yin
yang he ), which is yet a more explicit way of referring to sexual
intercourse.As theSuwen says about youngmen:Atagesixteen, their
kidneyqi is abundant, their heavenly power arrives, their essential qi
overflows,andtheyhavetheirfirstemissions.Oncetheyharmonizeyin
yang,they canhavechildren(1.3).GuoAichuncommentsthatharmo
nizeisthesameasunite(he).ThescholarsfromtheShandongand
Hebei medical schools state that it is synonymous with man and
woman uniting sexually (1995). A similar expression also appears in
Mawangdui,inthetitleofthesexualmanual Heyinyang.
However,theSuwenalsousestheexpressionwithoutsexualconno
tations,whenittalksaboutthepulsethatmatchesyinandyang(17.4)
and when itclaimsthat onepersons ideasarenot in conformitywith
theyinandyang[theories] (67.1).
Use and Sleep

Anothercommonwordforhavingsexisthesimpleworduse(yong).
TheYangshengfangemploysittodenoteintercourseinoneofitsrecipes
forincreasingwomenssexualdesire.TheTianxiawarnsagainsttooag
gressiveapplication:forexample,useviolently(baoyong)and use
forcefully (qiangyong ). It refers to potential health hazards from
having intercourse when thepenis isnot ready, such aspustules anda
swollenscrotum.1 TheSuwenalsoappliesthewordinthismanner:
Whenmajoryincontrolstheseason,damp qi descendsandkidneyqi ascends
accordingly,blackarisesandwaterchanges,dustcoversand becomesclouds
andrain.Thentheqiinthechestpossiblyisnotsmoothandthereisyinflac
cidity [yinwei ]. Qi is greatly weakened. Then [the penis] will not rise
[buqi ] andcannotbeused.(70.3)
1 Harper1998,429n3;seealsoPfister2003,47;MaJX1992,10323.Wilehas
itasifheisexcessiveinsex(1992).SeealsoLiLingandMcMahon1992.
ThescholarsoftheShandongandHebeimedicalschoolscomment
thatwhentheqiinthechestisnotflowingsmoothly,yinflaccidityoccurs
andyangqiwillweakengreatly,sothatthepeniscannotriseandorbe
used (1995). Guo Aichun explains that yin flaccidity causes the qi to be
weakenedandresult insexualdysfunction. The Lingshusimilarlysays:
Whensomeonehasaninjuryinhispenis,theyin[penile]qiwillbesevered.
Thenitwillnotriseandcannotbe used.Still,themans bearddoesnotfall
offwhywouldthatbe? (65.2.1)
Disorderofthevesseltendons:ifdueto cold,therearecrampsin thetendons;
ifduetoheat,thetendonsslackenandcannotreceive[qi].Thenthereisyin
flaccidityand[thepenis] cannotbeused.(13.1.12)
Whenthediseaseisattheforkofthetoeintheleg,thereispain ontheinside
oftheankle,theinnerfibulas,andthepenis.Theinnerthighwillhaveturn
ingmuscles[spasms],and thesexualorgancannotbeused.Iftheinjuryisin
ternal,thenitwillnotrise.Iftheinjuryis [externaland]duetocold,it will
contractinward.(13.1.6)
Otherusagesofbuyong,cannotbeused,intheSuwenandLingshu
include statementslikethefourlimbscannotbeused(sizhibuyong
), indicating paralysis or stiffness. However, in the above contexts
yongclearly means to use [the penis] for sexual intercourse and not for
urination, and buyong isusedtodenote erectiledysfunction.
Anothercommon word to describe sex isto sleep(wo ), which
mostlymeansjustthatbutonoccasions,it has a sexualundertone:
[Whenthecomplexionis]blackandthepulsereachesitsutmost,[thepulse]
is rising, firm and big. Then there is accumulation of [injurious]qi in the
lowerabdomenandtheyinarea[genitals].Thisiscalledkidneysyndrome.It
comesfromtakingcoldbathsbefore sleeping [havingsex]. (10.4.2)
Giventhecontextinwhichsleepisusedinthispassage,thereisa
high probability that it can be interpreted as going to bed to have sex.
Accumulation of injurious qi in the lower abdomen and sexual organs
usuallyispartoftheetiologyrelatedtoproblematicsexualintercourse
inthiscasetakingcold bathsandhavingsexualintercourseimmediately.
86 / Chapter Six
Effort and Exertion

Another dimension of sex in the Suwen is the physical exertion it in
volveswhichmayleadtoexhaustionanddepletionofessenceandqi.It
has fivetypesofoverexertions orfivetaxations(wulao):
Protracted looking injures the blood; protractedsleeping injuresthe qi, pro
tracted sitting injures the flesh; protracted standing injures the bones; and
protractedwalkinginjuresthetendons.(23.1.12)
Sleepingheremaybejustlyingdownandrestingoritmayhave
a sexual implication, indicatingthat excessiveandprolongedsexualac
tivity causes physicalfatigueandexertion. Thecaseismadeabitclearer,
whenthetextsays:Whenoneisexhausted,qi isdissipated...whenone
isexhausted, onebreathesfastand perspiresheavily(39.4).And:Ifone
iscourageous[sexually]andexertsoneselfstrenuously,thenthekidneys
willperspire (61.1.2).
Physical exertion, also through sexual activity which causesheavy
perspiration, often leads to depletion of essence andkidney injury. Al
readythecasehistoriesofChunyuYishowthatsweatingisoftenassoci
ated with sexual intercourse. Exertion in the Suwen, depending on the
context, can therefore, imply overexertion through sexual activitynot
unlikethe violent and forcefuluse ofthepenisinthe Tianxia.
Another symptom associated with this are dreams of sexual inter
course,linkedwithdepletionandexhaustion(xulao)intheJingui
yaolue (EssentialsoftheGoldenCabinet)byZhangZhongjing
(150219) (Chen2003,15658).
Another variant is the pursuit of sexual activity with courage and
vigor(yong). TheSuwennotesthatifoneiscourageous[sexually]and
exerts oneself strenuously, the kidney will leak (61.1.2). Wang Bing
comments that having sex with courage and being overly exhausted is
called vigorous chamber [activities] (lifang ). Guo Aichun agrees
thatyongherereferstosexualactivity.Courageandvigorbythemselves
arenotharmful, butwhentheyareusedexcessively andleadtoexertion,
whetherinoroutofthebedchamber, theymaycause healthissues.

Yetanothertermofthesameilkisstrongforce(qiangli ).The
Suwensays:
Whenwindtakesresidence[inthebody]andcreateslascivious qi,itcauses
lossofessence.Theinjurious[qi]harmstheliver.Thus,whenoneovereats,it
causes tendons and vessels to slacken and intestines to suffer. This in turn
leadstopiles.Similarly,ifonedrinksexcessively,qiwillreverse[itscourse].
Asaresult,whenonehasstrongforcesex,kidneyqiisinjuredandthehigh
bonespoiled.(3.3.2)
Wang Bing comments that strong forcehere means to exert oneself

vigorously in sexual activity, implying excessive and pathological be
havior thatcauses diseasesandharms health.
Intheprogressionofchangeinthemedicalfield,thewordsusedto
expressthesexualactmovedfrombeing moreimplicitand metaphorical
to being more explicit and clinical. Older expressions such as uniting
yin and yang, joining man and woman, and harmonizing qi no
longerplayaroleintheSuwen.Insteadspatialdescriptions,suchasen
tering the chamber or penetrating the vagina become common. The
sexual act is described in terms of physicality and the various move
ments that accompanyitleaving lesstotheimagination anddetailing
morecorporalassociationsand specificobservations.
If people,despite all warnings,continue to engage invigorous sex
andexertthemselvesoveralongperiodoftime,theywillreachastateof
sexual exhaustion. This is called inner dissipation (neiduo ). The
Suwen defines it: When injurious qi is abundant there is excess. When
essential qi is dissipated, there is deficiency (28.1). Wang Bing com
ments that dissipation means a significant decrease in essential qi, to
thepoint even ofcomplete loss (duoqu ).HecitestheJiayijingindi
catingthatduocanmean to lust.Zhang Jiebing explainsduowith the
word lose (shi ). Generally, it means exhausted, empty, or
drainedandservesastheoppositeoffullness,abundance,orrepletion
(sheng).Itisclearlylinkedwithsexual activity,asinthefollowing pas
sage: Inner dissipation causes recession which leads to muteness and
lameness.Thesearesignsofkidneydepletion.Whenminoryin[qiofthe
foot]cannotarrive,wespeakofrecession(49.1). WangBingcomments:
88 / Chapter Six
Depletion is the state of being wasted. . . Kidneyqi is inwardly dissipated
and no longer follows[the rightcourse]. Thiscauses thetongue to be mute
andthelegstobelame: thisiskidneydepletion.
Wu Kun2 commentsthatinnermeanssexual exertion whiledis

sipatemeanstoexhaustonesyin.ZhangJiebinstatesthatinnerdis
sipation is the dispersion of essential qi (Leijing 14.11). Guo Aichun
addsthatdissipation meansexcessivesexualdesiresthatmay develop
intoseriousdepletion,whichinturnmayleadstothelossofvoiceand
weakeningofthelimbs(yinpai ).ZhangJiebinfurthersaysthatde
pletioniscausedbyinnerdissipationofessentialqibecausetheqi,be
ingindepletion,goesupinsteadofflowingdown (Leijing 15.34,27.33).
Theexpression innerdissipationcan thereforebe interpreted as a
euphemism for sexual exhaustion, caused by dissipating or dispersing
personal essence. Following the same line of argument, dissipation
aloneisusedfor inner dissipation:
[Even]apersonofstrongconstitution,ifhedissipateshisessenceinthefall
andwinterbyusing[thepenis],lowerqiwillascendandbecomeaggressive.
If it cannot return, essentialqiwill overflow and descend. Theninjurious qi
willascendinitswake.(45.1)
WangBingcommentsthat dissipationhappenswhenmanydesires
exhaust essential qi.ZhangJiebin adds that by giving in totoomuch
sexual desireone willdissipate essentialqiofthe kidney(Leijing15.34).
AlongthesamelinesYangShangshansaysinhisTaisu:Apersonwho
is strong and vigorous gives in to desires. When his yangqi is weak in
fallandwinterandheentersthechamberexcessively,hewillsufferin
jury.Forthisreason,wespeakof dissipationdueto use[ofthepenis].
Thecommentariesindicatethattheworddissipationusuallycon
tains only an indirect reference to the weakening of essence and qi and
canalsomeanreduceorcontend(see17.3,27,74.3.2,15.3,46.6,and
71.1).Inotherwords,thetermmaynotnecessarilybeconnectedtosex,
but, especially when used with essence or inner, sexual activity is
oftenimplied.
WuKuns HuangdineijingSuwenwuzhu,published
in 1594, has been evaluated by Sivin as exceptionally clear in its explanations
andgroundedintheexperienceofpractice(1993,204).
2
Pathologies
Anothertermforpathologies associated with sexual activityis hidden
twists(yinqu ).Scholarsandpractitionershaveinterpretedtheterm
differently,seeingitasawordforgenitalia(maleorfemale),sexualfunc
tioning, andexcrement.TheSuwenusesitfirstwithasexualconnotation:
Thesickness ofthetwoyang affectsthe heartand spleen.Then aman
cannotperformthehiddentwists;awomanwillhavenomonthlyflow
(7.2). WangBingexplains:
Twoyang indicates the yangbrilliance vessels of the large intestine
andstomach;hiddentwistsmeansaffairsthatarehidden,concealed,
indirect, and twisted. When the large intestine and stomach are dis
eased, the heart and spleen are affected. When the heart is affected,
bloodwillnotflow properly;whenthespleenisaffected, theflavorsare
nottransformedright.Whenblooddoesnotflowproperly,thewomen
cannotmenstruate;whentheflavorsarenottransformedright,theman
willhavelessessence.Asaresulthecannotperform theactsofthehid
den,concealed,indirect, and twisted.
ZhangJiebincomments:
Theinabilitytoperformthehiddentwistsisasicknessofthewayofyang
[penis].Thestomachisconsideredtobetheoceanthatcombineswater,grain,
qi,andblood;itisresponsibleforthetransformationofconstructiveandpro
tectiveqi aswellasformoisturizingtheancestraltendon....Now,whenthe
source ofthesetransformations is diseased,the way ofyang[penis]will be
weakenedexternally.Forthisreason,themancannotperformsexually.(Lei
jing30.6)
Thus, Wang Bing insists that the condition is caused directly by a

disorderoftheheartandspleen,whereasZhangJiebinbelievesthatthe
source of the ailment lies in the stomach vessel.3 He agrees with Wang
Bingwhenhenotesthatwhenamandoesnothaveenoughessence,he
3 InChineseMedicine,sexualdesireisseenasafunctionofthestomachin
termsofappetite.
90 / Chapter Six
cannotfulfillhissexualfunction,andifawomandoesnothaveenough,
hermenstruationwill ceaseorbeirregular.
Though there is a slight difference in opinion on interpreting the
diseasemechanism,they all agreethattheterm hidden twistsrelates
to sexual function.Incontrast to this,Yang Shangshan intheTaisusays
hiddentwists[means]stoolandurine(ch.3).GuoAichunagrees.In
the Tang, the term appears in general literature in the sense of sexual
organs. This is attested in the biography of An Lushan (703757) in the
XinTangshu(225.6420),who issaidtohaveoften suffered from genital
sores(yinquchangchuang). Anotherpassage has:
Theappearanceofkidneywind[ismarkedby]profusesweating,aversionto
wind,apuffyandswellingface,spinalachesthatpreventonefromstanding
upright,asootcoloredcomplexion,andtheinabilityofthehiddentwists[to
function] smoothly. The key diagnosticsigns are abovethe jaws, which are
black.(42.2)
WangBingnotesthathiddentwistsrefertoalocationthatishid
den,concealed,indirect,andbent.Thekidneyisthelocationthatstores
essence which,dueto sexual intercourse, is attackedby wind.Then es
sential qi diminishes inward and the affair of the hidden, concealed,
indirect,andtwisteddoesnotfunctionsmoothly.ZhangZhicongadds
thatthekidneyisresponsibleforstoringessence,andwhenthe Shaoyin
[kidney]andYangming[stomach]Vesselsgatherattheancestraltendon,
[injurious] wind will harm kidneyqi. Then the hidden twists will not
[function]smoothly.
MaShiagrees,butYangShangshanagainreadshiddentwiststo
indicatestoolandurine.Hisexplanationisthatifboththestomachand
thelargeintestine arediseased, one willnotbe ableto eliminatewaste.
Thisiswhyitiseasytodevelopdiseasesrelatingtoexcretion.Thismay
be true, but given the context and the other commentaries it is more
likely that hiddentwists referstothesexualactororgans notfunction
ing properly. The Suwen supports this: If sores develop inside the yin
[sex organs], the hidden twists will not [function] smoothly (74.2.4).
Soresinsidethesexualorgansarecalledyinzhongnaiyang .Such
sores may affect urination but not necessarily impede defecation. It is
thereforemorelikelythatthephrasehasasexualconnotation.

The Suwenfurtherstates:
When the major yin[qi] is atthesource, dwellsand dominates,the feet be
comelimp,the[bodys]lowerpartsareheavy,andstoolandurine[biansou
]areirregular.Whendampnessinvadesthelowerburner,itemergesas
stickyoverflowandcausesswellinginthehidden twists.(74.3.3)
This passage actually differentiates stool and urine from the hid
den twists. Zhang Zhicong comments that the term hidden twists
indicatesthelocationoftheanterioryin [genitals]ofmenandwomen,
i.e.,genitalia plus pubicregion. Thefollowing passages notesimilarly:
Deficiency in the Jueyin [vessel] causes swelling and pain in the lower ab
domen, belly distension,and difficulty inunimpeded urination[jingsuobuli
]. In addition, patients like to lie down with bent knees, and their
yin[genitals] shrinkandswell.(45.2)
Excessqiinthebodyappearsasbellydistensionaswellasdifficultyinun
impededurination.Whenthereisdeficiency,thefourlimbscannotbeused.
(62.2.4)
TheoneexceptiontotheruleisthefollowingSuwen passage,where
hiddentwists mightactuallybeexcretion:Whenthethirdyinandthe
thirdyangbeattogether,theheartandabdomenbecomefull.Ifthisde
velopstoitslimit,oneisunabletoperformthehiddentwistsandwill
diewithinfivedays(7.3).Allthedifferentcommentatorsagreethatthe
phrasehererefersexcretion.Whichmeansthatthetermhiddentwists
reallyhasallthesedifferentconnotations:maleorfemalepudenda,sex
ualfunctionandsexualintercourse,eliminationandexcretoryfunctions
of the body. In all cases, it indicates an energetic interaction of the hu
man body with the outside world, a movement of qi that is fluid and
curvyandnotobviousto thenakedeye.
Chapter Seven
Sexual Energetics
When male and female blend their essence, a new spirit is born.
Yijing
Asinmanyancientcultures,theancientChineseusedcorrelativethink
ingto classifybasicparadigmsofthe humanexperiencesinaworldgov
erned by the laws of nature. Thus, Edmund Ryden states that binary
terminology is apervasive feature of early Chinese philosophy and es
sential to the Chinese language (1997, 13). He refers to an unpublished
manuscript by B. J. MansveltBeck which lists some fifty contrasting
pairs,includingheavenearth(tiandi),abovebelow(shangxia ),man
woman (nann), fathermother (fumu ), henrooster (cixiong ),
cowbull(pinmu),etc.(1997,13n34).1
Over time, binary thought patterns provided the basic notion that
the cosmos is a dynamic process which emerges from the continuous
interaction oftwocomplementaryforces(Hinsch2002, 144).Therewas,
therefore,ashiftfromdescriptivetocausal,correlativecosmologies.The
classification schemesinduecoursebecametheoriesthatcouldaccount
forthemechanisms bywhichthingswerecorrelatedand howtheyinflu
encedeachotherinacosmosthatwasassumedtobeconstantandgov
erned by the laws of nature (Peerenboom 1993, 227; see also Graham
1986).
1 For more on dualism in ancient China, see Ryden 1997, 1339; Graham
1986,7091;Peerenboom1993,22529;Hinsch2002,14556;Unschuld2003,8389;
Cammann 1987, 10116. For medical yinyang theory, see Porkert 1974, 943;
Sivin1987,20308.
92
Sexual Energetics / 93
The YinYang System

The most important of these binary concepts is the pair of heaven and
earth in three major dimensions: as physical, visible entities (tiandi); as
archetypal cosmic patterns symbolized in the Yijingtrigrams Qian and
Kun;andasactive,dynamicpotencies,representedbytheforcesyinand
yang. It isnot surprising that theancientChinese appliedthisdualistic
systemtothesexes.
TheSuwenusesbinary patternsin varyingdegrees:forthegeneral
description of things, philosophical abstractions, and genderization. It
hastheword qianmainly in its literalmeaning toindicatedrynessor
aridity, a parched or dehydrated state (5.2.4). The word kun appears
only once, in reference to the earth but without the connection to qian
66.4).Heavenandearthasconcreteentities,ontheotherhand,appearin
just about every Suwen chapter, usually in the sense of the greater uni
verse.Thepairhenroosteris seen five times: ithas the general sense
offemalemaleorfemalenessmaleness(4.2,4.3,75.1,77.2,79.2).
Byfarthemostimportantbinarypairisyinyang,thefoundationof
medical theory and traditional Asian cosmology. One yin, one yang,
that is the Dao, says the Great Appendix (Dazhuan ) of the Yijing.
The terms originated from geographical observation, indicating the
sunnyandshadysidesofahillandwrittenwiththecharacterforhill
nexttothoseforsunandshade.Theyfirstappear intheShujing
(BookofHistory)andtheZuozhuan,whichbothgobacktobeforethe5th
century BCE. However, in both texts they may be later interpolations
(seePeerenboom1993).
NeithertheLunyunor the Zhongyong (DoctrineoftheMean)
and the Daxue (Great Learning)chapters of the Lijiall texts of
theEasternZhouhavethem. AsW.AllynRickettnotes, theGuanzi
(Book of Master Guan), a3rdcenturyBCE text, makes no references at
alltoYinYangdualism(1955,155).TheMozi (BookofMasterMo)
mentions theconcept onlyvaguely. As ArthurWaley notes, thisshows
thateveninthelateZhoutheyinyangtheorywasnotwidelyaccepted
(1956, 11012). Both early Daoist texts, the Daodejingand the Zhuangzi,
make ample use of yin and yang, but they were edited comparatively
late,inthe3rd centuryBCE.
94 / Chapter Seven
TheShiji creditsthethinkerZouYan (ca.350270 BCE)withthe
formulation of the yinyang pattern of energetic change into a compre
hensive cosmological theory (ch. 74). R. P. Peerenboom argues that al
thoughcorrelativeparadigmsofyinyangandthefivephasesmayhave
existedlongbeforehim,theirsystematicdoctrinewasonlydevelopedin
thelateWarringStatesperiodandcametofullfruitionintheHan(1993,
22527).
Sex is yin and yang in action; yin and yang are sex writ large
(Wile1992,11).Thisistrue,butmanyscholarsalsoconcurwithBernard
Karlgrenontheinterpretationofyin andyangandthinkoftheirsexual
rolesas alaterinterpolation.Hestates:
It is certainly doubtful whether the word yin conveys in the beginning a
clear sex notion, which may be regarded as a philosophical abstraction of
latertimes;butthereisnodoubtthatthecombinationofyinandyangsigni
fies the combined action of heaven and earth in the production and trans
formationofbeings,orthecreativepowersofthetwogreatforces.(1930,12)
As yinyang thoughtbecamemore elaborate, itbegan to appear in

allthedifferentdimensionsofChineseculture.BytheendoftheHan,it
waswidelyappliedtomedicine,whichatthesametimereachedahigh
degreeofsophistication(Lu1980,113).Atthesametime,yin andyang
became ubiquitous symbols for man and woman or maleness and fe
maleness in medical theories. The yinyang theory to intellectuals and
philosophersmaybeanabstractprinciplethatpermeatesthemicrocosm
within themacrocosm,butforlaypeopleit isthebasiccharacteristic of
allthingsasbasedonthelawofnature.Atsomepointitbecameappar
ent that in order for human beings to survive and reproduce, the co
existenceandinteractionofopposite,complementaryforcesandentities
werenecessary.AstheZhuangzinotes,Ifallwerehensandnonewere
roosters,how would therebeeggs? (ch.17)
YinyangappearsfourtimesinSuwenchapter titles(chs.5,6,7,79)
and166times over42 chapters. Heavenisyangand earthisyin;thesun
is yang and themoon is yin,itsays (9.2). Yin and yang explain thebi
nary structure of the Dao (5.3); they describe vessels and pulse condi
tions. As single entities, they have even wider meanings. For example,
yang denotesnot only themale genderbut alsothemale sexual organ.
Ontheotherhand,yin describesnotonlythefemalegenderandthefe
male generativeorgans,but indicatesall genitals. It alsocorrespondsto
the adjective sexual as in the term yinwei for a syndrome called
yinflaccidity.
TheSuwenexpoundstheimportanceofyinandyangastheprinci
palforcesofcreationofthe universeandhumanity:
YinandyangformtheDaoofheavenandearth,the[principallawof]crea
tion of the myriad things, the change and transformation of father and
mother, the root and beginning of birth and death, and the palace of spirit
brilliance.Totreatdiseases,onemustseekouttheroot.Thereforeitisimpor
tant to understand that in the beginning accumulated yang [ascended] to
form heaven and accumulated yin [descended] to form earth. Yin is calm,
whileyangisrestless.Yangisbirth,whileyinisgrowth.Yangcontrolskill
ing,whileyincontrolspreservation.Yangtransformsqi,whileyincompletes
thebody.(5.1)
Similarly, Qi Bo uses the law of yinyang and nature to explain

howonecanachievelongevity:
PeopleinantiquityknewtheDao.Theylivedwithinthelawofyinandyang
andmaintainedharmonywiththeartsofdivination.Theyweremoderatein
eatinganddrinking,regularinrisingandretiring.Theydidnotusereckless
ness to tirethemselves out. Therefore, they could keep body and spirit to
getherandwereabletorealizetheir[allotted]lifeexpectancyofoverahun
dredyears.
Peopletodaydo not[liveinaccordancewith]nature.Theydrinkalcohol
likebroth,theyemployrecklessnessinalltheiractivities,theyenterthebed
chamberinanintoxicatedstate,theyallowtheirlusttoexhausttheiressence,
theylettheirwastefulnessdissipatetheirtrue[qi]...Hence,whentheyget
tofifty theyarealreadyweakandsickly (1.1)
ThesetwoexamplesshowthatbythetimetheSuwen wascompiled
the yinyang doctrine was firmly established in both health care and
medicaltheories.Atthesametime,thetwoforceswerealreadygender
izedreflecting the most fundamental characteristics of health care in
thehistoryofmedicine.IntraditionalChinesemedicine,thisgenderiza
tionisencapsulatedinthenotionthatbloodisyinandqiisyang(5.3).2
2 SunSimiaohasthesamestatementinhisBeijiqianjinyaofang(Emergency
PrescriptionsWorthAThousandPiecesofGold,2:14)inwhichhesaysmanis
ruledbyessence[qi]andwomenbyblood.Foradiscussionongenderdifference
96 / Chapter Seven
Already in its first chapter, the Suwen thus describes how men and
women develop differentlyat age fourteen girls begin to have a
monthlyflowofbloodandareabletohavechildren,whileboysby
agesixteenhaveoverflowingqi andbegintoejaculate(1.3).
Sexual physiologies strengthen this difference, according to which
man emits semen and woman menses. The genderization further in
cludes a differentiation of the pulse sensation in man and woman as
stated in the Maijing (9.1) and Nanjing (19th Issue). Thus, Sun Simiao
statesthatthedisordersofwomenaretentimesmoredeeprootedand
hardertocurethenthoseofmen.
In the sexual realm, the Suwen mentions specific treatment of
women for menstrual problems, conception, pregnancy, delivery, and
postpartumstates. Men,ontheotherhand,aretreatedforsexual,mainly
erectile,dysfunctionandinvoluntarilyseminalemission.Closelyrelated
to this genderization are further binary pairs, which culturally come to
be associated with men and women respectively: exterior and interior
(77.2, 75.1), outside and inside (4.2), above and below (16.5), left and
right (15.2), highandlow(74.2.1),andexcessiveand deficient(ch.28).
IntheHan,theyinyangpairbecamethedefining basisofall binary
thinking. New, contrasting terminologiesless abstract and more spe
cificanddirectionalwereaddedandcametobeusedindescribingthe
medical body. Yinyang thinking defined sex and medicine, yet the re
verseisalsotrue:theincorporationofsexandgenderintomedicaltheo
riesstrengthenedyinyang thinkingandmadeitmorepervasive.
Essence
Thefundamental dynamicsofsexualactivityinChinesemedicalthink
inghaveremainedfairlyconstant.Theycenter ontheenergeticfunctions
ofessence(jing),kidneyqi(shenqi ),andthreeoftheeightextraor
dinary vessels: Governing, Conception, and Penetrating, which run
throughthehumantorso.
Qi mightbethelifeforcethatpropelsallthingsbetweenheavenand
earth but jing gives life and defines sex. Jinghas been translated vari
in sickness and gender difference in the Yellow Emperors body, see Furth
1999,2548.
ously as essence, vital essence, semen, seminal fluid, and re
productive fluidall terms that fall short of what it really embodies.
Jingindicatesawiderconcept;itisnotjustasubstance,visibleormeta
physical. Idefine itasaparamountform of energythat ismore refined
andsublimethanqi. Forthelackof betterword,Istill callit essence.
Thoughnot as ubiquitous as qi, essence in Chinese thinking is un
derstoodas thequintessenceoflife,thematerialthatenablesthecreation
oflifeandtheuniverse.Onthemicrocosmiclevel,itisthemostimpor
tant concept shared by medical and sexual traditions (Wile 1992, 20).
NathanSivinadds:
Ching[jing]meansontheonehandthemaleorfemalereproductiveessence
[as in semen], the origin of life, and on the other the essence produced by
metamorphosisfromalimentarynourishment.[Itbecomes] thematerialbasis
ofphysicalgrowthanddevelopment. (1987, 24243)
ManfredPorkerttranslatesjingasunattachedstructiveenergyor
structivepotentialwaitingtotakeform(1974,17680).Fromthepoint
ofsexandsexuality,LiLingandKeithMcMahonstate:
Essencerefersbothtothefluidemissionandwhatisstoredinthebody,that
is,theessentialcomponentsnotyetformedintosemen,especiallytheinnate
vitalenergyoftheindividual.Essenceisusedwithrespecttobothwomen
andmenandit[also]referstothefluidsofthevagina.(1992,162)
Rodo Pfister calls jingthe lifegiving juice par excellence, found

notonly inman and womanbutin allother living things. Based onhis
reading of the Lshi chunqiu (3.2), he describes it as something that is
tangible and always in motion. He interprets it as a pale, slimy, and
lightly viscous excretion ofliving things.Essenceappearsalso invari
ous body fluids, such as sweat, tears, saliva, snot, urine, and stool, ex
creted either voluntarilyorinvoluntary(2010,13.1,13.2).
The Zhuangzi statesthat utmost essence hasnoform,justasutmost
vastnesscannotencompasseverything(ch.17.1),implyingthatessence,
evenatitsminuteness,isstillanimportant core componentingivinglife
andformtothemyriad things.
The Inward Training (Neiye )chapter of the Guanzistarts by
saying: The essence of everything is that which gives life: below, it
brings forth the five grains; above, it creates the starry constellations.
98 / Chapter Seven
When [essence] flows between heaven and earth, it is called demon or
sprite.Whenitisstoredinsomeoneschest,theperson iscalledasage
(seeRoth1999,46).
In this instance, the sage on earth is paired with the demons or
sprites of the otherworld. In other words, when essence has a physical
bodytoresidein,itcreatesacelestialconnectionandasubtlewayofbe
ing inthe world,described assageliness. When ithasnophysicalbody
to return to, it roams freely between heaven and earth and becomes a
divineentitymoreoftenthannotdescribedasa spriteandassociated
withmischiefandmalevolence(Lingshu58.2).TheSuwen,too,mentions
thatitisuselesstotalkaboututmostvirtue(zhide )tothosewhoare
possessedbysuchademonorsprite(11.0).Itmakesitclearthatessence
hastohavearesidence,aconnectiontoamaterialbase,sothatitcanbe
concentrated and exist as a structured entity. In this context, the
Huainanzi (BookofthePrinceofHuainan;dat.145BCE) says:
People of the world should know. . . when desire is banished, it is able to
propagate.Whenitisabletopropagate,therewillbetranquillity.Whenitis
tranquil,thentherewillbeessence.Whenthereisessence,thenitcanstand
alone.(see Majoretal.2010)
SimilarlytheGreatAppendixtotheYijingsummarizesthecreative
matrix and reproductive element of essence: That which gives life is
called essence. When the essences [of male and female] unite, this is
called spirit. It also stresses that sexual intercourse is the fundamental
way of universal life and the manifestation of the cosmic forces of yin
and yang in action. Next, it says: When heaven and earth [provide]
generative forces, the myriad things transform and take shape. When
male and female blend their essence, the myriad things transform and
come forth (Sect.4).
Hellmut Wilhelm explains that the way of the Creative [yang]
bringsaboutthemaleandthewayoftheReceptive[yin]bringsabout
the female (1950, 28586). Seen from these philosophical works, es
senceisthe fundamentalmaterialandreproductiveelementthat gives
lifeanddetermines theconstitutionofallthings.
Harnessing Essence
Essenceisapreciousbutlimitedresourceanditsevanescencehastobe
prevented. Rodo Pfister lists various methods to replenish it or at least
preventitfrombeinglostduringsexualintercourse(2011,I:3.3).Thefact
that men and women lose their essence during sexual intercourse is
widelyacknowledgedinChinesemedicine(2011,I:3.5.2;Syed1999).But
men lose essence mostly through ejaculation while women lose it
throughmenstruation.
TheSuwen usesessencetomeanboththe foundation of life (4.1)
andsemenasin reducedamountofsemen(jingshao )(1.3).Italso
associates the term with something called essential fluid (jingye ),
whichmayincludeseminalorsexualfluids(71.2.2).Inaddition,itlinks
it with the quintessence of the cosmos in the form of essential qi(1.4),
andwithsexualenergyingeneral(1.3).
Essenceasthefoundationofthebodyisthemostbasicsubstance
that shapes the individual and maintains all vital activities. It directly
affects growth, development, sexuality, aging, and death in both men
andwomen(1.3).TheLingshu confirmsthiswhenitstatesthatnormally
[what] develops before birth is called essence (30.1)connecting the
concept to the idea of primordial matter that existed before creation. It
alsonotes,inaparaphraseoftheYijing,thatatthebeginning,wespeak
ofessence;whenthetwoessences[ofmaleandfemale]mix,wespeakof
spirit (8.1.2). Essence is thus the quintessential matter that gives life.
Whentheessencesofamanandwomanintermingle,theresultiscalled
spiritthecreationofanewhumanbeing.
The Suwen states that essence is transformed into qi (5.2.3)
implyingthat essenceisthefundamentalsubstancerequiredforthe crea
tionofanindividualwithanewspiritconsciousness(Hertzer2006,199
201).TheLingshuexplains:Atthebeginningofapersonslife,thefirst
[physiological entity] to be completed isessence. When essence is com
pleted then brainandbonemarrowwilldevelop (10.1).
Thesepassagesdescribe essencebefore thecreation of the individ
ual. It can thus beconsidered as themost primordial and original sub
stanceoftheuniverse.Thatisthemacrocosmicview.Inthemicrocosmic
world, essence exists in the bodies of the parents;at conception its two
100 / Chapter Seven

aspects,inthemaleandfemale,intermingleto createanewlife.Thenew
individualisthenendowedwithafixedamountofthispreciousmatter,
which determines just how many years heaven is giving him or her in
thislifetime.
Essence iseverywhere inthebodybut storedchiefly in the kidney
organ (4.3), from where it is distributed to other parts as needed. The
Suwen cautions that exhausting ones essence has farreaching conse
quences, speaking of this lifesapping state as essence is exhausted
(1.3), essence has perished (3.3), essential qi is weakened and de
stroyed (19.2), essential qi is exhausted (45.1), essential qi is dissi
pated (28.1), and essenceisdissipated (21.1).
Thediminishingandeventualexhaustionofapersonsstockofes
senceinevitablyleadtoprematureagingandearlydeath.Suchdiminish
ingoccursduetooverindulgenceinsexualactivity,excessiveeatingand
drinking, indulgence in too much sexual intercourse, having sexual in
tercoursewhileintoxicated,andgivingintoallsortsofunbridledcrav
ingsandlusts. Asthe Suwensays:
Attheageofsixtyfour,amansheavenlystockisexhausted,hisessencedi
minishes,the storage[capability]ofthekidneyweakens,andthewholebody
reachesitslimits.Atthispoint, heloseshisteethandhair.
The kidney rules water and receives theessence ofthefiveorgans and
sixvisceraforstorage. Thus,whenthefiveorgansarefilledabundantly[with
essence]itcanemit withease.But ifthefiveorgansareweakened,tendons
andbonesdegenerateandhisheavenlystockwillcometoanend.Then,the
hair[onhishead]andathistemplesturnswhite,hisbodygrowsheavy,he
nolongerwalksupright, andcannothavechildren anymore. (1.3)
According to Qi Bo, a dissolute, immoderate lifestyle invites sick

ness and shortens life. More than that, having sexual intercourse while
intoxicatedandlettingsexuallustexhaustonesessence cancutlifeby as
muchashalf.WangBingcomments:Taking[excessive]pleasureinsex
is called lust; using [ones essence] lightly is called dissipation. When
there is no temperance in sexual pleasure, essence will be exhausted.
Otherpassagesthatblametheexhaustionofessenceinconnectionwith
sexualactivitystate:
Ifstomach[qi]isnotharmonious,essential qiwillbeexhausted.Whenessen
tial qiisexhausted, thefourlimbswillnotbenourished.Forsomeonewhois

frequentlyintoxicated,ifheentersthebedchamberwhilefullysatiatedwith
food, qi gathersinsidethespleenanditcannotbedispersed. (45.1)
When wind takes up residence [in the body] and creates lascivious qi, it
causesessencetobelost.Theinjurious[qi]harmstheliversothat,whenone
overeats, tendons and vessels will weaken and the intestines will suffer,
whichinturnleadstopiles.Forthisreason,ifonedrinksexcessively,qiwill
reverse[itsregularcourse],andwhenone usesstrongforce[physicallyand
sexually],kidneyqi isharmed andthethighbonespoiled.(3.3.2)
TheChinesehavealwayscautionedagainstexposuretowindwhileen
gaginginsexualactivity.Thelossofessencetogetherwithoverexertion
duringtheact certainlyimpairs health.
Theabovethreepassagesrelateexhaustionofessencetosexincon
junction with alcohol. The consequence of having sexual intercourse
while in an intoxicatedstate is loss ofcontrol over onesdesires,which
may lead to excessive sexual activity and the loss of essence through
ejaculation. Besides, alcohol also opensthepores, which leads to exces
sive sweating, dulls perception and feelings, and opens orifices that al
lowessence andvitalfluids toflowout.
The function of essence in male reproductive physiology and the
aging process involves reaching sexual maturity at age sixteen, when
kidneyqiisabundant,theheavenlystock,essentialqioverflowsandis
discharged, and whenthrough uniting yin and yang [sexual inter
course]hecan havechildren (1.3). The endofthecycle, too, has to do
withthepresenceandpowerofessence.Thus,aroundagesixtyfour,the
manfindshisessencediminishing,hiskidneycapabilityweakening,and
his body reaching its limits. He can no longer produce offspring (1.3).
Essentialqiherereferstothefundamentalsubstancethatshapesanindi
vidual whilethe essencethat lessens with agemight indicatethequan
tityofsemen,especiallysincethefirstpartofthepassagementionsthat
itoverflowsand can beemittedanobjectiveaction.
The core teaching of sexual cultivation in both medical and yang
sheng literature is to prevent the loss of essence, especially in men. The
main technique inthiscontext isreverting essencetonourishthebrain,
explained variously ascoitusconservatus(nonorgasmic intercourse),coi
102 / Chapter Seven

tus thesauratus (orgasmic intercourse), or coitus reservatus (retention of
semenwithorwithout orgasm).3
The technique appears first in the Mawangdui text Shiwen, which
describesanexercisethatteachesthemantoabsorbhispartnersqiand
transform it into essence before circulating it upward. The Tianxia ex
plains the method of constricting the anus to avoid outflow of essence,
whiletheHeyinyangmentionsthatoneshoulddrawessenceandspirit
upwardandsendthe[essential]qitothegenerativegate.TheSuwen
doesnot mentionitfortwopossiblereasons:first,asamedicalbookand
notasexualmanual,itwouldnotfocusonthesepractices;second, itmay
well assume that those who consult it would have prior knowledge of
thetechniqueand need noelaboration.
Byallaccounts,essenceisanequallyimportantcommodityforthe
survivalofbothmenandwomen.Itisspecificallyrequiredforsuccessful
procreationinthemale,anditsexhaustionaffectsthereproductiveabil
ity. However, theSuwen does notmention it in its discussionof female
reproductivephysiology, focusing instead on bloodwhich may be in
terpretedasthefemaleformofessence.Ontheotherhand,itstatesthat
essencecannotfunctionalonebuthastoworkintandemwiththerestof
thebodytomaximizeitsroleinsexualfunctions.Thus,theLingshusays:
Blood, qi, essence, and spirit give rise to life and regulate the natural
characteristicsofaperson (47.1).
Essencealsooperatescloselyinrelationtoqiand spirit whenpeople
work to achieve the transformation to immortality; this psychological
perspective has early roots (Hertzer 2006, 20910). However, essence is
describedasaphysiologicalelementconnectedtotheindividualandto
spirit, butneverinconnectionwithdemonsorsprites.Thisisyetanother
sign that theSuwen wasmoving away frommagicospiritism to amore
formal,theoretical medicine.
3 For detailed discussions on these terms, see Harper 1998, 13639; Wile
1992,5859;Pfister2011,I3.5.1.
Qi
QiisthemostubiquitousconceptinbothsexualcultivationandChinese
medicine.ItistheuniversalforcethatpermeateseveryaspectofChinese
thinking and it plays a fundamental role in longevity doctrines and
medical theories.Much hasbeen written about qiboth in philosophical
andmedicalcontexts.
Moderntranslationsofqi,besidestheubiquitousenergy,include
finestmatterinfluence(Unschuld2003,14967),vapor(Harper1998,
11225),vitalforce(Chan2002),flowevent(Pfister2011,I:2.3.6),and
pneuma (Robinson2004). AccordingtoNathanSivin,thetermhastwo
main senses: one is physiological function or motive force, and the
otherissubtle,refinedmatterwhichhasanutritivefunction(1997,237
40).4
Manfred Porkert lists thirtytwo categories of qi (1974, 16773). In
addition, A. C. Graham states that qi is adapted to cosmology as the
universalfluid,activeasYangandpassiveasYin,outofwhichallthings
condense and into whichtheydissolve. ..It is like such words in other
cultures as Greek pneuma, wind, air, breath. It is the energetic fluid
whichvitalizesthebody,inparticularasthebreath,andwhichcirculates
outside us as the air (1986, 101). Benjamin Schwartz discusses the
etymologyoftheterm(1985,180)andsays:
Chi [qi] comes to embrace properties which we would call psychic,
emotional, spiritual, numinous, and even mystic. It is precisely at this
point that Western definitions of matter and the physical which
systematically exclude these properties fromtheir definitions do not at all
correspond to chi. . . To the extent that the word energy is used in the
West to apply exclusively to a force that relates only entities described in
termsofphysicalmass,itisasmisleadingasmatter,Ithink,asanoverall
nameforchi. (1985,181)
4 Fortheconceptasusedinqigong,seeHsu1999,77879;inrelationtoves
sels and pulses in the Western Han, see Hsu 2001a, 1317; for its role in Han
dynastypulsediagnosis,seeHsu2001b;on qi andimmortality,seeKohn2001,49.
104 / Chapter Seven

In contrast, I would like to look at the early Chinese view of qi.
Moderntranslationswhichincludeideasandphenomenaofthatwhich
fillsthebody,thatwhichmeanslife, breathe,wind,air,vapor,steam,
life force,pneuma,vital force, and the likemaycontribute to its under
standing, buttheydonottellthewholestory.Theclosestapproximation
islifeforce, butaccordingtotheancientChinese,stoneshave qi, too.
TheDaodejingdescribesqiastheprimalenergyresponsibleforthe
transformation of Dao to achieve harmony: The ten thousand things
turn theirback on yin to embrace yang.Their qi intermingle toachieve
harmony(ch.42).ThisisechoedbytheZhuangzi:Thebigmass[nature]
exhales itsqi, and it iscalledwind(ch. 2.1).According totheLunyuof
Confucius,qi isthesourceofemotionalbehavior:
In youth, when blood and qi are not yet stable, one should guard against
lust.Afterreachingmaturity,whenbloodandqiisfirm,oneshouldguard
against aggressiveness. Having reached old age, when ones blood and qi
areindecline,one shouldguardagainstavarice. (16.7)
Similarly,whenMenciuswasaskedhowhecouldmaintainhiswilland
notviolatehisqi,heanswered:Whenthewillisconcentrated,itmoves
qi;whenqiisconcentrated,itmovesthewill. ... Fallingandrunningare
[themanifestation of]qi(Mengzi3A.2).AndtheHuainanzispeaks ofqi
inrelationtobody and spirit (ch.7).
Alan Chan connects qi andthe heartmind (xin ), explainingthat
the Han dictionary Shuowen jiezi (Explaining Characters and
Explicating Phrases)definescourage(yong)as qi, sothat itisan ex
pressionofstrength,aforcing(qiang) ofqionanobject(2002,4647).
Courageasafunctionofqithusgivesitaconcreteratherthanmoralistic
tone. Thisshedsadifferentlightonideasof courageandforceinrelation
to sexual intercourse. The Suwen uses strong force (3.3.2) while the
Tianxia speaks of use strongly to express sexual activity. The Suwen
alsosaysthatifoneiscourageous[sexually]andexertsoneselfstrenu
ously,thekidneywillsweat(61.1.2).
AsYoshinobuSakadenotes,itisimpossibletogainaproperunder
standingofChinesemedicinewithoutreferencetolongevitytechniques
includingsexualcultivation, sincebothadheretoafundamentalbeliefin
qi, which makes up the human body and allows human beings to gain
andretainlife(1989,18).Qiispartandparcelofthemacrocosmandmi
crocosm. As the Suwen says: Heaven and earth exist in the above and

below of the myriad things; yin and yang exist in the blood and qi of
man and woman (5.3). In the realm of sex, qi is often associated with
essence.Though theSuwen doesnot directly imparttechniques onhow
toconserveorgenerateessenceliketheMawangduimanuscripts,itstill
cautionsmennottoallowexhaustionoftheiressentialqi(45.1)oritsdis
sipation (21.1). Either leads to dire consequences, such as loss of repro
ductivepower,physicaldecay,andprematuredeath.
The Suwen mentions over fifty kinds of qi found in the body and
nature. In one passage, the Yellow Emperor notes: When the qi [of
heaven and earth] unite,there willbeform.Due tothis transformation,
propernamesarecreated(9.4).Hereqiis thecosmic energythat gives
risetothemyriadthingsbutthereisalsotheqiofthetwentyfoursolar
nodes,describedinatechniquecalledqishu (qi calculation)orjieqi
(nodalqi)(LiZG 2005,131n5).QiBoexplainshowthe360segmentsor
daysof theyearand thoseofthe body (joints)aredetermined:
The sixand six[sixtydays andsix cycles]segments andthe nine and nine
systemsareusedtodeterminetheheavenlyprogress[tiandu]whilethe
qicalculation[ofthetwentyfoursolarnodes]isusedtocoordinatetransfor
mationandgrowth[intheseasons]. (9.1)
Themost important tenet insexualcultivation isthemanipulation

ofqi (Lo2001,4146),whichinturnisencapsulatedinthedoctrineofthe
seven ways of diminishing and eight procedures of increasing [qi]
(qisun bayi ). The Tianxia states that qi has eight ways of being
increased and seven ways of preventing its diminishing. The former
include exercises that teach the practitioner to regulate, absorb, and
hoard qi. The latter involve rules on how to make sure that qi is con
servedandprotected. TheSuwen states:
Ifoneknowsaboutthesevenwaysofdiminishingandtheeightprocedures
of increasing [qi],bothcan be regulated.If one does not knowabout them,
thereisearlyweakeningofthejoints.Atageforty, theyin [sexual]qi isdown
tohalf,andallrisingandmoving[dailyactivities] areweakened.Atagefifty,
the body [feels] heavy and ones ears and eyes are no longer acute. At age
sixty, theyin[sexual]organswillbelimp,theqiisgreatlyweakened,andthe
nineorificesdonotfunctionsmoothly.Thereisdeficiencybelowandexcess
above:snotandtearsflowout!(5.4.2)
106 / Chapter Seven

Italsosaysabout qiinsex:
When emotions and lust are unbridled, endless worry and anxiety come
about;then essential qi isweakened anddestroyed.(14.2)
Ifoneentersthebedchamberwhileintoxicated,qiisexhaustedandtheliver
injured.Hence, themensesarescantordonotcome. (40.1.2)
Ifoneisfrightened,thereisaccumulationofqiinthechest.When[thepulse]
israpidanddepleted,itiscalledlungblockage[with]coldandhot[spells].It
is contracted by letting [the penis] inside [the vagina] while intoxicated.
(10.4.2)
Duetodrunkenness,qireversesitcourse.Becauseof[using]strongforce[in
sexualactivity],kidneyqiisharmed. (3.3.2)
For someone who is frequently intoxicated, if he enters the bedchamber
while fully satiated with food,qigathers insidethespleenand it cannot be
dispersed.Also,whentheqiofalcoholandthat ofgraincontendwitheach
other,abundantheatis[generated]inside.Asaresult,thereisgeneralfever,
internalheatandtheurinewillbereddish.(45.1)
TheLingshu further supportsthe roleofqiinsex,by saying thatwhen

the receding qi. . . resides in the sexual organs, one dreams of contact
with the inside [of the vagina or inner chamber] (43.3); and when a
manhasaninjuryinhissexualorgan,the[flowof]yin[sexual]qiissev
eredandhecannotraiseit[hasanerection];therefore[hispenis]isofno
use(65.2.1).
Qiisthusthepillarofsexualcultivation; itrulessexualhealth.Al
though the text does not give advice on how to manipulate qi through
the sexual act, its authors were certainly aware of these methods and
clearlyspeakofthevariousharmfulandadvantageousprocedures
The Kidney System

Thegraphshen appearsfivetimesintheMawangduimedicalcorpus,
but only onceitmeanskidney.TheYinyangshiyimaijiujinguses it in
conjunction withthepathway of theminor yin vessel.Intheother four
passages,shendenotesthetesticlesbothhumanandanimal.TheYang

sheng fang mentions the use of dried rat testes in making medicinal
patches. The Wushier bingfang has two recipes for inguinal swelling
whichinvolveenvelopingthetesticlesingourds,plusonethatservesto
curetesticularabbesses.Thesepassagesshowthatkidneyasanorgan
and medicalconcept wasgraduallydeveloping.
TheMawangduitextsdonotmentionthesystemofthefiveorgans
andsixviscera(wuzangliufu),whichisubiquitousintheSuwen.
As Douglas Wile notes, shen is often misleadingly translated as kid
neysortherenalsystem(1992,20).Itisessential,especiallyinregard
tolifeandsex.5 Infact,shencanalsobethecollectivedesignationforthe
entireurogenitalcomplex,whichincludesnotonlythekidneysbutalso
thetestes,urethra,andurethralopening.Tomakethisfactclear,inthis
work I use theterm kidneysystem forthiscomplex andkidney as
thatbelongingtotheorgans.
Thekidneysystem,liketheotherstoringorgans(liver,heart,spleen,
andlung)isconsideredyin(4.2),whiletheprocessingvisceraareyang.
Wang Bing sees the kidney system as a yin depository situated in the
lower burner and calls it yin residing in yin and yin within yin.
Yang Shangshan states that the kidney and liver systems are situated
belowthediaphragmandapproachingthelowestarea.Hence,theyare
yin innature.Asthe kidneysystemcorrespondsto water, and water is
major yin,hecalls ityin within yin.The Suwennotes thatthe kidney
systemisayinstoringorgan(61.1.2)and callsittheorganofwater(44.2).
It stores the will or intention(23.1.10) and rules thebones(23.1.11)and
marrowofthebody(44.1).
Noneofthe organsandvisceraeverworks alone; theirfunctionsare
always interconnected. The kidney system rules water. It receives the
essence of the five organs andsixviscera and stores it.Thus, when the
fiveorgansarereplete,[thekidneysystem]distributes[itthroughoutthe
body] (1.3). This passage implies that essence is accumulated from all
theorgansand storedparticularlyin the kidneysystem for furtherdis
tribution.Thatiswhydeficiencyofkidneyqiaffectsallthedifferentas
pects of the body, especially the kidneys. When essence in the kidney
systemisreplete,kidneyqiisabundant;whenitisdeficient,itdeclines.
Thisinturncauses physiologicalweakeningand decline.
5 See also Sivin 1987, 2268; Porkert 1974, 140146; Unschuld 2003, 13643;
Pfister2011,I:3.4.3.
108 / Chapter Seven

LaterCCMand modernTCM bothconsider thekidney asoneofthe
five zangorgans or repositories, whose main function is storing.
Theythereforebelievethatitisunabletohaveexcessintermsofyinand
yang.However,boththeSuwenandNanjingstatethatthekidneyisable
tohaveexcess whichmay causepathologicalchanges.
Inaddition,thekidneysystemruleswinter;itisthebasisforseal
ing[thebodytopreventleakage]andforstoring[essence].Itisalsothe
residence ofessence(9.5).The kidneysystem asthe location wherees
senceisstoredisfurthersupportedintheLingshu,whichdescribesitas
the main reservoir of essence (8.3). Both are fundamental in health and
reproduction. The kidney system dominates the reproductive develop
ment inbothmen and women,so that girlshave abundantkidneyqi at
seven years of age and an even supply around age twentyone; boys
have fullness at age eight, abundance when they get to be sixteen, bal
ance at twentyfour, and then enter a gradual weakening and decline
witheveryfurthereightyearperiod (Suwen1.3)
Thekidneysystemiskeytoreproductive physiology,sexualmatur
ity,andaging.Abundantkidneyqiinbothmaleandfemaleisrequired
forconception ofchildren;itsdeclineaffectsfertilityandhastensbodily
disintegration, leading to increasing susceptibility to illness, premature
aging, and death. Vessel dynamics and organ function, combined with
the Conception and Penetrating Vessels, also play an important role in
female fecundity, but the center of command remains in the kidney
system,where essenceisstored(4.3).
The kidney system is also directly involved in sexual intercourse.
AstheLingshuhas:Ifoneentersthebedchamberexcessively,perspires
andbathesinwater,thekidneysystemisharmed(4.1.1);and:[After]
usingexcessivestrength,if[theperson]entersthe bedchamber,perspires,
and takesabath,thekidney systemisharmed (66.4).
The complex correspondence network of the kidney system is as
follows(seeTable1):

TABLE1
KIDNEYSYSTEMCORRELATIONS
CORRELATION AREA
viscera
directions
six climates
fivephases
nineorifices
tissues
colors
tones
vocalsounds
fiveflavors
emotion
disorders of five organqi
fiveessentials
secretions
orifices
spiritqi
domesticanimals
movementatchange
diseases
grains
stars
numbers
odors
manifestations
laboractivities
pulseconditions
transformations
wildanimals
order/affectation
coldseason
variation
disasters
qi
season
KIDNEYRELATION
urinarybladder
north
cold
elementwater
ears
bone
bonemarrow
black
fifth tone
groaning
salty
fear
yawning
SUWENPASSAGE
70.5
5.3,4.3,67.5.6
5.3, 23.1.4,67.5.6,
5.3,4.3,607.5.6,1.3,9.5
5.3,4.3
5.3,4.4,23.1.11,67.5.6,1.3,
23.1.7, 67.5.6,44.1,9.5
5.3,4.3,67.5.6
5.3,4.3
5.3
5.3, 23.1.1,4.3, 10.2, 74.5.4,
67.5.6
5.3,23.1.3,67.5.6,80.1
23.1.2
fear
saliva
doubleyin
essence
pig
shivering
largejoints
(soy)bean
Mercury
six
putrid
will
longstanding
rockyorheavy
solemnity
scaled
motionless/calm
fallingsnow
frozen andcold
violenthailstorm
solid
winter
23.1.3
23.1.5
4.3,70.1.1
4.3
4.3
5.3
4.3
4.3
4.3
4.3
4.3
23.1.10
23.1.12
23.1.13
67.5.6
67.5.6
67.5.6
67.5.6
67.5.6
67.5.6
67.5.6
7.1,9.5
110 / Chapter Seven
Extraordinary Vessels
The main term for all kinds of qi channels in the Suwen is mai . This
includes both primary paired vessels (jing ) and complex, collateral
networklines(luo)(47.1.1). Anotherusageofthetermmaiistoreferto
the pulse and to palpation as in thispassage: The pulse can be weak,
strong, slippery, choppy, floating, and sunken; it can be distinguished
with the fingers (10.4.2). In the context of sexual cultivation, the most
importantarethreeamongtheeightExtraordinaryVessels:theConcep
tion Vessel (renmai ), the Penetrating Vessel (chongmai ) and the
GoverningVessel(dumai ).6
These three have five special functions relating to the genital and
reproductiveorgans:1)regulatingqi;2)circulatingessence,constructive,
andprotective qi;3)connectingthemajorvessels;4)connectingprenatal
andpostnatalessenceandbuildingitup;and5)supplyingessence tothe
six extraordinary viscera, i.e., the brain, bone marrow, bones, cells,
uterus, and gallbladder (see Kirschbaum 1995, 2634; Lu 1980, 4552;
Furth1999,2944).Theirmainjobistoholdessentialqiforthebenefitof
thebodyandpassingitontothevesselsandviscera.However,notwo
medicalbooks agree on theiroriginand functions.What, then, are they
specifically?
According to the Suwen, the Conception Vessel has twentyeight
acumoxa points (59.1.8). It startsbelow the Central Ultimate (zhongji
), at apointcalledMeeting Yin (Huiyin),locatedbetweenthe ex
ternal genitals and the anus, and ascends to the suprapubic hair line
(60.1.3; Nanjing #28). The Lingshu, in contrast, states thatboth the Con
ceptionandPenetratingVesselsbegininthecenteroftheuterus(65.2.1).
The Suwen adds that it travels up along the [midline of the] torso
through the point Primordial Pass (Guanyuan )located three
inches belowthenavel(Hempen2000,24647)toreachthethroat;from
there it ascends to the cheek and follows the face to enter the eye
(60.1.3). The Lingshu further indicates that branches of the Conception
TheotherfivearetheBeltVessel(daimai ),YangLinkingVessel(yang
jiaomai),YinLinkingVessel(yinjiaomai),YangHeelVessel(yang
weimai ),andYinHeelVessel(yinweimai .
6

Vessel encircle the mouth and gums (65.2.1),7 where it also connects to
various collaterallines.
AsfarasreproductivediseasesconnectedtotheConceptionVessel
areconcerned,theSuwensaysthatwhentherearepathologicalchanges
in the Conception Vessel, a man contracts the knotted seven protru
sions[disease][jieqishan ] internally,whileawomandevelopsab
dominalmasses belowthebelt(60.1.3).
MostmodernChinesemedicaldictionariestranslateshanashernia,
aconditioninwhichanorganortissueprotrudesthroughanopeningin
its surrounding walls, especially in the abdominal area.8 The Shuowen
jiezi defines it as abdominal pain (futong ). The Suwen says that
when the pulse is sunken and weak, it indicates that coldheat has
reachedtheprotrudedmass tocause abdominalpain (18.3.1).The Shi
ming (ExplainingNames),aLaterHandictionarycompiledbyKong
Xi , glosses it as heart pain (xintong ). The Suwen also makes
this connection when Qi Bo explains to the Yellow Emperor that when
the heartpulse is rapid, it indicates a disease called heart protrusion
(xinshan)(17.5).
The Penetrating Vessel, too, which runs through the center of the
torso,hasdifferentstartingpointsintheclassics.TheSuwensaysthatit
beginsatthepointQiThoroughfare(Qijie , St30)and[runs]paral
lel to the primary vessel of minor yin along both sides of the navel. It
branches out once it reaches the middle of the chest (60.1.3). The acu
In TCM, the Conception Vessel is also known as the Ocean of Yin be

causeitfrequentlymeetstheyinvesselsofthehandandfoot.Itissaidtobere
plenishedwithqiandbloodfromalltheyinchannelsofthebody.Thecharacter
ren for conception also means pregnancy. Since the channel is thought to
arise fromthe uterus in women, it is also relatedtoreproduction andtherefore
responsibleforthesupply of bloodtothefetus. SeeKirschbaum 1995,6792;Li
ZL1991,910;ShanghaiCollege1990,252.
8 The Cihai notesthat shan refers to: 1)symptomscaused by protrusion of
contents in the body cavity, for instance, a part of the intestine that protrudes
fromtheabdominalwall,thegroin,orthelowerpartofthecavityofthescrotum;
2) troubles ofthe external genitalia, thetesticlesandthescrotum, characterized
byulcerativelesion,swellingandtheoutflowofpusandotherturbidsubstances,
and the swelling and pain of the testicles and the scrotum, or accompanied by
abdominal pain; 3) severe abdominal pain, accompanied by difficulty in urina
tionandconstipation(35.1.5).
7
112 / Chapter Seven

moxapointQiThoroughfare,accordingtotheJiayi jing,isalsoknownas
Qi Penetration (Qichong ). It is located five inches below the navel,
abouttwoinchesonthesideoftheanteriormedianlinenearthegroin.9
However,theLingshugivesitsoriginastheuterus,thesameastheCon
ceptionVessel(65.2.1).Yetitalsosaysthatitistheoceanofthetwelve
major vessels andstartsfrombelowthekidney system [testes](62.4).It
furtherexplainsits relationshipwithotherqi channels:
The Penetrating Vessel isthe oceanof channels. It is responsible for per
meatingandirrigatingtheravinesandvalleys[musclesstructures]. Itjoins
withtheYangmingattheancestraltendon,whereallyinandyang[vessels]
unite.Itisthegathering[point]oftheancestraltendon.
ThechannelscometogetherattheacumoxapointQiSurge[Qichong
].HeretheYangming becomesthe leader. They are all relatedto theBelt
Vessel10 and linked to the Governing Vessel. For this reason, when the
Yangmingisdepleted, theancestraltendon weakens, theBeltVesseldoesnot
pull,thelegsbecomeflaccid,and theycannotbeused.11 (44.3)
The Penetrating Vessel has twentytwo acumoxa points (59.1.9).

Anypathologicalchangescausetheqitoreverseandgiverisetopainin
theabdomen(60.3).
ThethirdofthekeyvesselsinthiscontextistheGoverningVessel.
The Suwensays:
The Governing Vessel starts from the lower abdomen and moves down to
the center of the [pubic] bone. In women it runs through the genitals and
connects with the hallopening [urethra], which is at the end part of the
urethralcanal.Itsnetworklinefollowsthe[external]sexualorgansandcon
In TCM it is used to treat hernia, incontinence, menstrual irregularities,
andvaginaldischarge(Hempen2000,10001).
10 Unlike these vessels, that each have their own acumoxa points, the Belt
Vesselshasonlypointsthatalsobelongtootherchannelsandformabeltaround
the waist. In TCM, its most important function istosupply essenceto genitals,
hips,andwaist.TherearetwoBeltVessels,locatedinthelowerpartofthewaist
andabovetheiliaccrest.Theymeettheothervesselsatarightangle.SeeKirsch
baum1995,93113; LiZL1991,910;ShanghaiCollege1990,2523.
11 InTCMthePenetratingVesselascendstothehead,permeatingthewhole
bodyandservingasacommunicationscenterforthecirculationofqiandblood.
Itregulatestheqiandbloodofthetwelvepairedvesselsandisseenastheres
ervoirofblood.Itiscloselyrelatedtomenstruationandfemalereproduction.
9

nectsintheareaaroundtheperineum[betweenvaginaandanus].Aftercir
cumventingtheperineum,itbranchesoutaroundthebuttocks.
At about the middle of the network line, it meets the [foot] Shaoyin
[kidney] Vessel and the [foot] Taiyang [bladder] Vessel. It first unites with
theformerand togethertheyascendfromthebackoftheinnerthightopene
tratethespineandconnectwiththekidneysystem.
Fromherethetwo merge withtheTaiyangvessel.Theyemergefromthe
innercornersoftheeyesandascendtotheforehead,thenconnectatthetop
ofthehead.Theyenterandlinkwiththebrain.Turningaround,theyleave
[thebrain]again,thenbranchoutanddescendalongthenecktofollowthe
shoulderbladesinward.Fromheretheymovealongbothsidesofthespine
toreachthemiddleofthewaist.Theyenterandjointhespinalcolumnand
thusconnectwiththekidneys.
Inmen,theGoverningVesselruns alongthepenisanddescendstothe
perineum;fromthere,itisthesame asinwomen.Itascendsdirectlyfromthe
lower abdomen to penetrate the center of the navel, ascends further and
passesthroughtheheart,thenentersthethroat.Fromhereitascendstothe
chinandencirclesthelips,thenascendsandconnectsatthecenterbelowthe
eyes.12 (60.1.3)
TheGoverningVessel,whichrunsnearthespinealongthebackof
thebody,hastwentyeightacumoxapoints(59.1.7).Pathologicalchanges
meanthatqirushesupfromthelowerabdomentotheheartandcauses
pain.Thepatient cannotpasswaterandfeces,sufferingfromacondition
called surging protrusion (chongshan ). It is often described as a
diseasecausedbyimpairmentoftheGoverningVesselmarkedbysud
denpaininthelowerabdomen,whichsurgesuptotheheartandstom
ach and down to the testes. Women suffering from this disorder will
havedifficulty gettingpregnant andtheybe easily afflictedby illnesses
relatingtourogenital system.
Femalereproductivephysiologyischaracterizedbythepenetrabil
ityoftheConceptionVesselandtheabundanceofthePenetratingVessel
at age fourteen, whichmeans women are abletohavechildren. Onthe
otherhand,bothvesselsareweakanddepletedbyagefortynine,which
12 In TCM the Governing Vessel runs along the midline of the back, fre
quently meeting the three yang vessels ofthe hand and foot. It governs all the
yangvesselsofthebody.Itisalsoknownastheoceanofyangvessels.Italso
runswithinthespinalcolumnanddividestoenterthekidneys.SeeKirschbaum
1995,4066;LiZL 1990,911;ShanghaiCollege1990,25051.
114 / Chapter Seven

signals the end of the childbearing years (Suwen1.3). Wang Bing com
mentsthatwhen[theflowof]menstrualwaterisseveredandstopped,
itwill cause the earthchannel [ofthe uterus] tobeimpenetrable.When
both vessels weaken, her body is injured and she can no longer have
children. Alldescriptions makeitclearthatthethreevesselsareessential
for female reproductionunlike in men, where they are important for
developmentandgrowthbut notlinked toreproduction.
All these channels, moreover, connect to the face, the mouth, and
thelips.Thus,theLingshustatesthatifamansPenetratingVesselisin
jured, for example, by castration as in the case of a eunuch, he cannot
grow a beard (65.2.1). Similarly, if hisConception and Penetrating Ves
selsare deficient,even thoughpenis andtesticlesmay be intact,he still
lacksthe qiandbloodtonourishhislipsand mouthtogrowabeard. The
threevesselsarethusimportantforcertain aspectsofsexualhealth and
development.
Chapter Eight
Sexual Anatomy
Enter the mysterious gate. Ride the coital tendon.
He Yinyang
Van Gulik notes that the medical fields of obstetrics, gynecology, and
sexualanatomyhaveabearingonsexuallife,althoughhehimselfdid
not explore them in any detail(1961, XVII). TheSuwen supportsthisby
portraying sexual anatomy as dealing with parts of the body that con
tribute to its overall system of diagnosis, prognosis, etiology, and pa
thology.
Suwen anatomical knowledge is derived rather than observed and
does not seem to have been based on dissection.1 The Lingshu, on the
otherhand,makesclearreferencestodissection(jiepo ),emphasizing
thatthedeadwerecutopentoascertainthestructureandplacementof
the internal organs (12.2). It gives measurement of the bones (ch. 14),
presents the dimensions of the vessels (ch. 17), and provides the exact
sizeofintestinesand stomach.2
ThevocabularyusedforsexualanatomyintheMawangduimanu
scriptsis colorful,imaginative,andmetaphorical.Forexample,thepenis
is called jade whip (yuce ) in the Shiwen and Yangsheng fang, and
red infant(chizi ) in the Shiwen.The female sexual organs arede
scribedwithspecialcareandingreatdetailbecausethesexualmanuals
were written for men. For example, the Tianxia describes the vagina in
twelvepartsandtheYangshengfanghasadiagramshowingthevarious
terms for its different parts: red bead (chizhu ), zither strings
(qinxian ), uneventeeth (maichi),and thelike(seeFig. 10).
1 FordiscussionsofanatomyandsurgeryinearlyChina,see Kennerknecht
Hirth2009,2874;Yamada1991;Zaroff1999;Andrews1991.
2 See Lingshu chs.31,32; alsoin Nanjing,#42;andYamada1991.
115
116 / Chapter Eight
Fig. 10. Yangshengfang drawingofthevagina.
In the Suwen, the vocabulary for sexual and reproductive anatomy has
becomemorespecificandishighlycodified.Itisalmostasiftheauthors
assumed that their readers had prior knowledge of sexual vocabulary
and thus could decipher its meaning. It does not use any flowery lan
guagetoembellishthemaleandfemalesexualorgans;rather,ithasgone
clinical anditsvocabularyforsexualanatomyisexplicitandovert.
Sexual Organs
Themostcommon term used torefer tosexualpartsis yin .Itmeans
shadowy, hidden, inthe dark,but it isclearthat Suwenscholars,
physicians,andreadersknewthatyinwasacodewordusedforsexand
sexuality, used mostly to denote the female gender and describe
womens genitalia.As Van Gulik notes:In latertimestheterm is used
exclusively for female and the female generative organs, but it seems
that originally it was employed for both male and female parts (1961,
71).Yin isalsoperceivedasthe hidden or forbidden parts,which in
clude sexual appendages, the anus, and certain parts of the urogenital
system (Pfister 2003, 89). The word also corresponds to the adjective
Sexual Anatomy / 117

sexuala typical example is yin flaccidity (erectile dysfunction),
whichappears twiceintheSuwen.
An earlier use of yin for the male sexual organ is found in the
Tianxia,wheretheYellowSpiritaskstheLeftSpirit:Whyisitthateven
thoughtheyin[penis]isborntogetherwiththenineorificesandtwelve
joints, it alone dies first? In the Shiwen (#5), Yao asks Shun the same
questionbyreferringtothepenisas yin.
The Suwen uses the term to describe the genitalia and/or anus of
bothmaleandfemale. Yin furtherappearsinvarious compound phrases,
such as yinyang for sexual intercourse, female and male, or female
and male sexual organs; sexual instrument (yinqi ); anterior yin
(qianyin ) for genitals;andtwo yin(eryin )forgenitals andanus.
Thefollowingtwopassages illustrate thatthe term alsodenotesthepe
nis:
When the lower back is painful and one cannot turn and move [the body],
and[ifthepain]pullsurgentlyattheyin[penis]andtesticles,insertneedles
into theeightopenings[acumoxapoints].(60.1.2)
ThedeficiencysyndromeoftheJueyin[vessel]willcauseswellingandpain
ofthe lower abdomen, distension ofthe belly, difficulties in defecation and
urination,andatendencytoliedownwithbentknees.Also,theyin[penis]
will shrinkand[scrotums]becomeswollen.(45.2)
Gao Shishi comments that the last phrase about the penis (yin
shuzhong ) meansthatthesexualorganshrinksandthescrotumis
swollen. This comment implies that yin in this passage represents the
malesexual organ.Othercommentators agreethatyinhereisan abbre
viationforthesexualorgan.Forexample,ZhangZhiconginterpretsitas
to mean anterior yin and Ma Shi as sexual instrument. These two
passagesintheSuwenaremalespecific.The Lingshuconfirmsthisusage:
Whenamanhasaninjuryinhisyin,the[flowof]yin[penile]qiissev
eredand[thepenis]cannotrise;[thus],theyin[penis] cannotbeused[in
penetrativesex](65.2.1).
Otherpassagesinthe Suwenthatuseyintodenote the sexualorgans
but are not genderspecific include the following: If sores develop in
side the yin, hidden twists [sexual intercourse] will not be favorable
(74.2.4).Zhang JiebincommentsthattheTaiyang Vessel isconnectedto
thekidney systemandcorrespondstothe bladdervessel.Henceitcauses
118 / Chapter Eight

soresinthesexualorgans.GuoAichunstatesthatthearea[aroundthe]
sexualorgandevelopssores.Anotherpassagestates:
[When the complexion is] black and the pulse is at its utmost, rising, firm,
andbig,thereisanaccumulationof[injurious]qiinthelowerabdomenand
the yin area. This is called kidney obstruction syndrome. One gets it from
taking cold baths and [immediately] going to sleep [sexual intercourse].
(10.4.2)
ZhangZhicongcommentsthatyinherereferstoanterioryin,i.e.,
thesexualorgans,whileMaShisaysitdenotestheinteriorofthesexual
organs.Itisbeyonddoubtthatthetermdenotesthesexualorganinthe
Suwen.
Avariantexpressionistwoyinwhichclearlyreferstothegenita
liaandtheanus.Forexample:Thekidneysystem...governsthetwo
yin (70.1.1); and: Entry and passage to the kidney system is through
theopenedtwoyinorifices (4.3).
IntheSuwen,thetwoyinformpartofthenineorifices (jiuqiao).
They are the eyes, nostrils, ears, mouth, and two lower openings.
Thoughwomenhavethreelowerorifices,theurethralandvaginalopen
ingsaretakenasone.Forapersontobehealthy,allninemustbepene
trable and open to free energetic flow. Any hindrance to their passage
wayisacauseofdisease,suchaswhenthe nineorificesareobstructed
(bijiuqiao;3.1),notpenetrable(jiuqiaobutong; 3.3.1),ornotfunctioning
properly(jiuqiaobuli; 28.4).
The nine orifices divide into the upper (seven) 3 and lower
(two/three) orifices.Posterioryinclearlyindicatesthe anusbutante
rior yin is a bit more complicated because of the physiological differ
encesbetweenmenandwomen.Anteriorandposterior(qianhuo)usu
ally referto excretory functions:Frontandback [orifices] areblocked
andnonfunctioning ofthe front and back [orifices]arephrasesmen
tioned in connection with urine retention and constipation (19.4.2; see
also45.2,60.1.3,63.2.6).
Anterior yin (qianyin ) frequently describes the genitalia of
bothmaleandfemale.Forexample,
3 The seven orifices (qiqiao) of eyes, ears, nose, and mouth are not men
tionedintheSuwen,buttheLingshureferstothem(17.2;78.2).SeeEnzinger2006.

Anterior yin is [the location] where the ancestral tendon gathers and [it is
also]wheretheTaiyin [spleen] andYangming[stomach]Vesselsunite.(45.1)
Whentheceasingyinsuffersfromrecedingandreversing[ofqi],contrac
tions, lower back pain, depletion, and fullness, then the anterior yin is ob
structedandnonsenseisspoken. (45.2)
Anteriorthusappearstoincludeurologicalfeaturesinsomepas
sages; it often appears as a composite with posterior. In combination
thetwohave thesamemeaningasthetwoyin:Whenthevesselisfull,
the skin is hot, the abdomen is distended, the anterior and posterior
[urological,sexualandanalpassages]areobstructed,and[onebecomes]
depressedandvexed.Thisiscalledfivefoldrepletion(19.4.2).
Scholars differ in reading anterior and posterior as urosexual
anal features. The scholars of the Shandong and Hebei Medical School
state that the term anterior and posterior indicates stool and urine
(1995).Thismightbe logically true,butthe Suwen uses dabianandxiao
bian to describe stool and urine, respectively. The interpretation might
differ, but etiologically it means the same. When the urological, sexual,
andanalpassagesareobstructed,urineorstoolcannotbepassed,which
may lead to depression and vexation. Two other passages that indicate
anteriorandposteriorincludeurological,sexual, andanalpassage:
When the disease arrives, first the patient has a fishy and gamy odor, dis
charges green fluid, and vomits blood. Then the four limbs turn green, the
eyes blur, and often the anterior and posterior [passages will pass] blood.
(40.1.2)
When ceasing yin suffers from recession and reversal, contractions, lower
back pain, depletion, and fullness, then the anterior [sexual organ] is ob
structedandnonsenseisspoken.Besttreatthisusing[points]thatgovernthe
disease.Ifallthreeyin[vessels]flowinreverse,onewillbeunabletoante
rior and posterior[urinate and defecate], and the persons hands and feet
willbecold.Afterthreedays[thepatientwill]die. (45.2)
While these various phrases are used in a unisex fashion, yin and
yangastechnicaltermsclearlyseparatethemalefromthefemaleinthe
naming of their sexual organs. For example: When both the yin and
yang[qi]areoverly abundant,[theywill]descendtothefemaleandmale
[sexual organs] (79.2). Guo Aichun cites Zhou Xuehai as saying
120 / Chapter Eight

thatiftheyinandyangqiareoverlyabundantandnotharmonized,it
meansthatthey havereachedtheirlimit.Onecancertainlyseethesymp
toms in the anterior and posterior yin. This shows that stool and urine
(erbian ) are obstructed from being discharged. Zhang Jiebin com
ments:
Ifyinandyangqiareoverlyabundant,theywillbecomeoverbearingand
harmful either to the yin or yang. If the disease becomes serious, it moves
down toreachtheyinyang [sexualorgans].Thisaffects thepenisinmenand
thevaginainwomen;itcauses imbalancedhiddentwists[i.e.,difficulties
inhavingsex]andeventuallydevelopsintoa seriousillness. (Leijing 13.7)
Ma Shi concurs that when both the yin and yang are replete, the
disease of the male will move down to the penis while that of female
reachesthevagina.Inthiscontext,theLingshuhasamorepreciserefer
enceofyinandyangassexualorgans.Itsays:Whencarbuncles[yongju
]grow in the yang[penis], in ahundred days [theman] will die;
whentheygrowintheyin[vagina],inthirty [thewoman]willdie (81.2).
Yang Shangshan comments in the Taisu that a mans yang organ is
calledyangwhileawomansyinorganiscalledyin.Carbunclesare
physicalstructuresthatcanbeseenonbodypartssuchasthesexualor
gans.Itwouldbedifficulttoconceptualizethemintermsoftheyinand
yangqioryinandyangvessels.Therefore,itissafetodeducethatyin
and yang in this passage represent the sexual organs of the woman
andman.
Another,relatedtermisyininstrument(yinqi). Yinqiisalittle
moreprecisethanjustyininitsusagetodenotethesexualanatomy.The
Suwensays:Thenetwork[lineoftheGoverningVessel]runsalongthe
sexual instrument [female genitalia] and connects at the perineum
(60.1.3). It also has this to say: The Jueyin Vessel follows the sexual
instrumentandconnectstotheliver[vessel].Thus,there willbevexa
tionwithfullness,andthescrotumwillshrink(31.2).
When the text, discusses specific disease mechanisms and deals
with the symptoms of febrile disease, it says that on the sixth day, the
JueyinVesselwillbeaffectedandsince itflowsaround thesexualorgans
andbranchesintotheliver,extremephysicalexertionwillcauseshrink
ageofthescrotum(ch.31). Shrinkageofthescrotumseemstobeasymp
tomassociatedwithdiseasesintheJueyinVessel.Hereitismalespecific
andyin instrumentrefersto the penis.The scholars ofShandongand

Hebei medical schools state that when ones heart is vexed and de
pressed, the penis and scrotum shrink (1995). This can be compared to
another passage, which states that when the anterior and posterior are
obstructed,thepersonbecomesvexedanddepressed (19.4.2).
The Lingshu contains many passages that describe the origin and
pathways of vessels. Itshowsclearly thatyininstrumentrefers tothe
genitalia.Thus,the stomachvessel issaidtostartattheouterflankofthe
secondtoe and ascendto gather inthesexual organs(13.1.3). The same
alsoholdstrueforspleen,kidney,liver,andgallbladdervessels,which
all start in somepart of the foot and equallyassemble at thesexual or
gans(13.1.46,43.3).
Thereisnodoubtthatyininstrumentintheabovepassagesrefers
tothe sexual organ ofbothmale and female.Addingthe wordinstru
ment to yin strengthens its usage as a term for genitalia. In this in
stance,yinisalsousedliketheadjectivesexualasinthetermyinwei
for a syndrome called yin flaccidity. Sexual instrument appears
both intheSuwen andtheLingshu, which indicates that it isastandard
termusedfor bothsexeswhichagainconfirmsthereductioninflowery
languageandthegradualdominanceoftheclinical.
Penis and Testicles

Male sexual organsare variously known in theMawangdui texts:jade
whip,redinfant,yangblaze(yangfu ),male(nan ),mem
ber (shi ) and penis (zui ).4 Western biomedicine ascribes three
functions to the penis: 1) as the male sex organ during coitus; 2) as a
channelthat leads urine from thebladdertothe orifice via the urethra;
and3)astheseminalvesiclesthatopenintotheurethraandthusallow
sperm and spermatic fluid to collect before expulsion as an ejaculate
(WagnerandGreen1981,723).
Inthe Suwenand Lingshu, thepenis ismostcommonlycalled stalk
(jing ).As the Suwen says, In a man [the Governing Vessel] travels
4 See Harpers list in the index (1998). I disagree with him that crowing
cock(mingxiong )isusedtodescribethemalesexualorgan.IreadtheShi
wen(#2) tomean thatoneconsumeamaturecockthatcrowsasanaphrodisiacto
gainpotencybecauseacrowingcockhasjing(1998,389).
122 / Chapter Eight

alongthestalk,thendescendstoreachtheperineum(60.1.3).Thisisits
onlymentionoftheterm,buttheLingshuhasmore.Itsays:Thebranch
vessel of the Jueyin Vessel of the foot . . . ascends to the testicles and
unitesatthestalk(10.5).Whenitmovesdown,thetesteswillbepain
ful and so will the stalk (49.2.3). In a man there are ten digitsstalk
andtesticlescorrespondtothem(71.2).And:Stalkandtesticlesarethe
instrument [located]inthemiddleofthebody(75.1.4)
IntheMawangduimanuscripts,especiallyintheWushierbingfang,
stalkcommonlyreferstoplantpartsusedinthepreparationofmedi
cal concoctions. This also holds true for medical texts, so that even the
Suwen uses the word as a botanical reference: stems and leaves are
witheredanddry(5.1).Theuseofstalktodenotemalesexualorgan
impliesanotherwayoflookingatbodydynamics.
RodoPfisterusestheconceptofgraftinginhisdiscussionofsexual
techniques and physiology. He compares the sexual act to agricultural
grafting: the man takes his stalk and grafts it into a womans slit.
The exchange of sap during the contact among plants is likened to the
exchange of qi in sexual cultivation. He refers to the consistent use of
wordssuchascontact(jie),usedforexampleintheShiwentodescribe
the sexual act(2011, I:3.6.1).Stalk soon becameacommon way of re
ferringtothepenisandispartoftheclassicexpressionjadestalk(yujing
).
Beyond this, the testicles arecommonlycalled eggs (luan ).Thus,
theSuwentalksaboutlower backpainthatmovesdownandimpactsthe
stalk andthe eggs (60.1.2).Italsosays:
When the [qi of the] Jueyin [Vessel] has reached its end, the central [torso]
willbehotandthethroatdry.Thereisatendencytourinateandonesheart
is vexed. When serious, the tongue curls up and the eggs [testes] rise and
shrink.Thisisit! (16.5)
TheLingshucallsthetesticleseggs oncewhenspeakingabouten
ergy moving down and causing pain (49.2.3); in two other passages it
callsthem droopers(chui ), once when referring topenisand testes
beingpart of amans digits (71.2), and once whendefining themas the
apparatus(qi)inthebodysmiddle(75.1.4).Thetesticlescanbeex
aminedbysight when it is swollen or through touch whenpain arises;
they are important tools forthediagnosis ofgeneralhealthbutnotdis
cussedasplayingamajorroleinsexualencounters.

The scrotum, next, is called the bag (nang ). Although not di
rectlyassociatedwithsexualactivity,itisessentialintheetiologyofdis
ease, because any pathological manifestation is clearly visible here.
Symptomssuchashavingaslack,droopy,shrunken,orswollenscrotum
helptodiagnoseor predict adisease. The Suwensays:
Onthe12th day,thediseaseoftheJueyin[Vessel]lessens[i.e.thepatientgets
better];thescrotumrelaxesandthelowerabdomendescendsslightly[tobe
morecomfortable].(31.3)
Onthe3rd day,if theShaoyangandJueyin[Vessels]areaffected,[thepatient]
becomesdeaf,hisscrotumshrinksandrecedes.Waterandgruelcannotenter
[thepatient] and hecannot recognize people.Onthesixthday, he willdie.
(31.5)
TheJueyinVesselfollowsthesexualorganandlinksupwiththeliver.Thus,
theremay bevexationwithfullness,andthe scrotumshrinks.(31.2)
Male sexual parts are thus clearly differentiatedpenis, scrotum,

andtesticles.Similarly,femaleparts,suchasbreasts,womb,andgenita
lia,are clearlyreflectedinthelanguageofthe Suwen.
The Breasts
The breasts are described as mammae or nipples (ru ). The
Mawangdui manuscriptsmention them variously. The Zubishiyimaijiu
jing describes the pathway of the Yangming Vessel of the foot as
emerging from the inner edge of the breasts. Similarly, the Yinyang
shiyi maijiu jing notes that its pathway ascends to bore [through] the
breast. These references are purely anatomical in nature and have no
sexualconnotation.TheTianxiaandHeyinyang,ontheotherhand,men
tion that the nipples harden (rujian ) as the woman is about to
reachaclimax.
TheSuwenwarnsphysiciansexplicitlyagainstusingneedlesonthe
breasts andgivesdetailsonwheretoapplyneedlesandmoxibustion:
Insertallneedlesabovethebreast.Ifyou[accidentally]hitthebreastcham
ber,itwillcauseswellingandcorrosionoftheroots.(52.3)
124 / Chapter Eight

Thelargecollateralvesselofthestomach goesthroughthediaphragmtolink
up with the Lung Vessel. It emerges from under the left breast and its
movement can be felt through clothing. This is the ancestral qi of the ves
sel . . . Below the breast one can feel its movement eventhrough clothing.
Thisiswheretheancestral qi comesout.(18.2)
The most common method to determine an acumoxa point is the

use of the fingers or thumb to measure in cun, which in the Han was
aboutaninchor,moreexactly,2.31centimeters(Harper1998,453).The
Suwen also uses the nipples as a marker to determine acumoxa points.
Forexample:TodeterminetheBackTransporters(Beishu )[orshu
acumoxa points on the back], first measure the [distance] between the
nipples[withapieceofgrass],thenbreakitinhalf(24.2).Also,The
qi of the Yangming Vesselof the foot emerges from 68 points. .. [They
are]parallelonbothsidesof[theacumoxapoint]TurtledoveTail(Jiuwei
,CV15]andaboutthreeinchesbelowthebreastsfiveoneachside
ofthestomachcavity(59.1.3).Thetextthususesnipplesasaclinical
referencetothebreasts.
Amongwordcombinations,nipplesinChunyuYismedicalcases
onceindicatesadifficultbirthintheexpressionnotabletousethenip
ples (buru)(Shiji105,#18).Nipplefeeding (rushi)isalsoused
inthecontextofbreastfeeding,butintheSuwenthetermreferstomilk
products in general: In the northern highlands, the weather is windy
andcold.Peopleliveoutintheopenand live onmilkproducts(12.1.3).
Anothertermforbreastfeedingisgivingnipplestothechild(ruzi
).TheSuwen has:
Duringpostpartumandwhilegivingnipplestothechild,ifthemother
getssickandfeverish,herpulseistiny.Whyisthat?...Ifatthistime
she is struck by windheat,she pants, utters [sounds], and shrugs her
shoulders.Then,whatisherpulselike? (28.2)
Guo Aichun identifies giving nipples as the state right after a

womanhasgivenbirth.ZhangJiebinusesthetermtorefertotheinfant
(Leijing 15.47).BreastsintheSuwen havebecomeclinical.
Uterus and Vagina

Another essential female sexual organ is the womb commonly called
uterus (bao ) and actively used in uterus vessel (baomai ),
uterus network lines (baoluo ), uterine qi (baoqi ), uterine
essence(baojing ),anduterineobstruction(bibao ).TheTaichan
shu (Book of the Fetus and Birth) from the Mawangdui corpus
uses the term to refer to the placenta or afterbirth, which was buried
rituallyinanauspiciousplacetoensurethegoodhealthandprosperous
futureofthechild. IntheSuwen, QiBoexplains:
Brain, marrow, bones, vessels, gallbladder,and uterus:thesesix aregener
atedbyearthqi.Theyareusedforstoragelikeyinandarestablelikeearth.
Thus,theystoreanddonotemitqi. Theyarecalledtheextraordinarypalaces.
(11.1;76.1) 5
Inorderforprocreationtotakeplacethe EarthChannel(didao)
oftheuterushastofunctionoptimally,whichmeansthatwhenawoman
reachesherfifties,herConceptionVesselisdepletedandherPenetrating
Vessel weakens. Then her Earth Channel becomes impassable and she
cannolongerhavechildren(1.3). ThisEarthChannelisinfacttheuterus
vessel, whichhastobe open forthe flow of the various substancesand
energies requiredforconception.Thewomansabilitytohavechildrenis
clearly connected to her menses or monthly affair (yueshi ). Any
conditionofmenstrualimpairmentperiodsbeingirregular,tooheavy,
ortooscantis tracedtotheuterusvessel:
Whenthemonthlyaffairdoesnotcome,thisiscausedbytheobstructionof
theuterusvessel.Itconnectstotheheartandthevariousnetworksinsidethe
uterus.Whenitsqiascendsandpressesagainstthelungs,theheartqicannot
descendsmoothly.Forthisreason,themonthlyaffairdoesnotcome.(33.4)
Theuterusvessel,oneofthemanyqichannelsdescribedintheSu
wen,connectstotheheartandhascollateralnetworkbranchesthrough
5 Thesameterminologyisstillusedtoday:theuterusisthechildspalace
(zigong)ortheuterinepalace(baogong).Sivinbelievesthatitencom
passesthewombauxiliarysystemanditsappendages(1987,230).
126 / Chapter Eight

out the uterine area. It is obstructed when qi moves upward and puts
pressureonthelungs.Thenheartqicannotdescendsmoothly,whichin
turnleads totheabsenceofmenstruationandinterfereswithconception.
However, even after the woman has conceived, the uterus vessel
has to stay healthy to bring the pregnancy to completion.If itdoes not
functionproperly,itcanplayhavocwith her health. Inonerecordedcase,
apregnantwomanhad becomemuteinherninthmonth.QiBoexplains
this as being due tothecollateral network vessel of the uterushaving
beensevered.Hecontinues:Itconnectstothekidneys;theMinorYin
Vessel penetrates the kidney organ and links up with the root of the
tongue.Thus, she couldnot speak (47.1.1).Healsosays:
Whenthepulsehasreacheditslimitandis[taut]like abowstring,itisdueto
theinsufficientcontributionofuterineessence.Ifshebecomesillandlovesto
talk,shewilldieasatthefirstfrost;ifshedoesnotspeak,shewillbecured.
(48.2)
WangBingcomments:
The uterus vessel is linked to the kidney organ; its vessel passes on both
sidesofthebaseofthetongue.When qiisinsufficient, thereistheinabilityto
speak.Inthepresentcase,onthecontrary,thepatientbecameverytalkative.
This is [a sign] that true qi has been interrupted internally. If it leaves the
kidneyandturnstothetongueandtoward theexterior,[thepatient]willdie.
ZhangJiebinaddsthattheuterusvesselislinkedtothekidneyves
sel, which in turn reaches the base of the tongue. So when uterine qi is
insufficient, thepatientbecomes quietandmute. However, inthiscase,
being talkative is a sign that yinqi is not contained. Yang Shangshan
adds: When there is excessive sorrow, thecollateral network vessel of
the uterus is severed. When this isthecase,yangqicannotmove inter
nally (Taisu44.2).In onecasehe alsousesthe wordbaoto indicatethe
pericardium(xinbao )(48.2).Similarly, Wu Kun identifiesbaoas the
sameas theessence chamber (jingshi).
Uterineobstructionisaconditionthatwillcausethe abdomenand
bladder to press against it, leading to internal pain (43.2). Most com
mentators read bao here as uterus but the scholars of the Shandong
andHebeimedical schoolsciteWang Yuanyu as sayingthatitrefers to
the urinary bladder (pangguang ). The precise meaning of bao, in
otherwords,dependsonthe context.

In some cases, qi is insufficient: If the carbuncle suddenly bursts,
thetendons[become]softandafteropeningthereisquiteabitof pain.If
perspiration continues unabated, uterine qi will go into depletion. This
needs to be treated with the [points] of the channel (28.3). Other dis
eases connectedtotheuterusinclude,forexample,conditionswhenthe
uterusmovesheattotheurinarybladderandthereis bloodintheurine
(37.3).
Judgingbythenumberoftimesbaoappearsastheuterus(13times
in9chapters),womensreproductivehealthformedanimportantaspect
of Han medicine. This is not surprising given the Confucian environ
ment with familycentered ethics, ancestor worship, and a strong em
phasisonhealthyoffspring.
TheobviousfemaleorganpertainingtosexmentionedintheSuwen
is thevagina.TheMawangduimanuscriptsname it variouslyas:dark
gate(xuanmen ),woman(n ),female(pin ),hole(xu ),
horse (ma ), inside (zhong ), jade hole (yudou ), and re
cess(bi )(Harper1998,517).NotonlyaretheMawangduitextscrea
tiveinthesenamesbuttheyarealsopreciseinnamingitsvariousparts.
Thus,theTianxiadividesthevaginaintotwelveparts:1)hairpinlight
(jiguang ),2)sealingcord(fengji ),3)drygourd(kuhu ),
4) rat wife (shufu ), 5) grain fruit (gushi ), 6) wheat teeth
(maichi),7)infantgirl (yingn ),8)departtoreturn(fanqu
),9)why remain(heyu ), 10)readthread(chil ),11)red
bead(chizhu),and12)leistone(leishi).6 Someofthesenames
alsoappear inthe Yangshengfangillustration(seeFig.10above).
TheSuwenusuallyresortstomoreclinicaltermsandjustcallsityin,
the femalepart (45.1). In somecases it also uses anterioryin(45.2)or
yin instrument (60.1.3). Similarly, it refers to the urethral opening as
urineaperture(nikong ),notingthatinwomentheGoverningVes
selconnectstoaspotatitstopendcalledthecourtaperture(tingkong
) (60.1.3). Wang Bing comments that court aperture is also called
obscureleaking (yaolou)andisclosetotheopeningofanterioryin,
i.e.,thevagina.ZhangJiebin,ontheotherhand,identifiesthecourtap
erture with the urine opening. Zhang Zhicong comments that it is the
female sexual organ, which is obviously wrong. The scholars of the
6 Ifollow Pfisters reading lei instead ofzao
. The leistone is around
pebble.Larger oneswere thrown atenemiesfromthecitywall(2011,I.4.1.113).
128 / Chapter Eight

Shandong and Hebei medical schools state that the court aperture is
theopeningoftheurethracanal.GuoAichuncitesSunDingyi to
supporthis ideathatcourtmeans yin. They all agree thattheGov
erning Vessel in women is linked to the urethral or vaginal opening,
whereasinmanitfollowsthepenisrighttothetip.
Except for the womb, all sexual parts described in the Suwen are
externalandcanbeidentifiedandunderstoodwithease.Itsknowledge
oftheinternal structure and physiologicalprocessesof thebodyconsti
tutesaninformed,deductionistabstractionlinkedtotheirexternalfunc
tions. Overall, the accuracy and precision of their observations are as
toundingas are their more abstract concepts, such as the ancestral
tendon.
The Ancestral Tendon

Theancestraltendon(zongjin )isanabstractconceptpertainingto
sexuality;itsexistenceisexpressedbyitsfunctionratherthanitsphysi
cality.ItisnotfoundinanyotherHanorlater medicaltext andisoverall
aratherconfusingandexcitingterm(foundsixtimesinch.44andonce
in ch. 45). Commentators throughout the ages have offered different
views on what it could be and where itmight be locatedbut generally
haveplaceditinthecontextof sexualorgans.
The dictionary Guangya (Extensive Poetic Analysis) identifies
zongwith zhong orall.TheShuowenjiezidefineszongasvenerable
ancestorsorthesource,origin(ben ).It citestheDaodejingassay
ingwordshaveanoriginandaffairshaveamaster. Zongcantherefore
mean baseorfoundation.Fromamore sociohistoricalperspective,
Bernard Karlgrensays:
Whattheancestor (zu ) istotheclanasawhole,thefundamentalpoint,the
eldestbrother(bo)istothelivinggenerationsoftheclan:heistheclan,
he carries it and respects it, he brings the sacrifices to the ancestors, he is
sometimes called, straight out, zong the clan man.He is the present pro
genitorofthefamilythemainman.(1930,6)
Zong is therefore ancestral, main, basic, key, focal, or

vital. Zhang Jiebin reads it to mean main, base, or foundation
(Leijing 5.11) or collect (18.79). The Suwen uses it in this latter sense

when it says: Water collected is accumulated water, which in turn is
utmost yin or kidney essence. The reason why this collected essence
water cannot be discharged is due to essence binding it (81.2). Then
again,itusesthetermto meanancestralwhenitspeaksofthe stomach
vessel moving underneath the breasts in a tangible mannerthis is its
ancestralqi(18.2).IntheLingshu,thetermmeansmainorvital.For
example: The eyes are where the main vessels gather (28.2.8); and:
Theearsarewherethevitalvesselsgather (28.2.11). Yet, zonggenerally
alludestoamainlocationorsourcewhereallormanythingscongregate
to form the foundation or base. It is therefore, a vital, main, basic, and
pivotalstructure.
The use ofjinismoreambiguous. Itcan refer totendons,muscles,
sinews,fascia,ornerves.DonaldHarpertranslateszongjinasmanifold
musclesanddiscussesitinconjunctionwiththetermjiaojin,which
hetranslatesascoitalmuscles(1998,414n3).DouglasWiletranslatesit
as coital sinew (1992, 78) while Rodo Pfister has crisscrossed ten
dons(2003,74).However,the compoundjiaojinisnotusedintheSuwen.
So,whatexactlyis jin?
TheLingshuprovidesadetaileddescriptionofthenatureandstruc
tureofjin(ch.13),oftenreferringtosomethingakintothenervoussys
temratherthan musclesand tendons.Itdescribesjinascorrespondingto
the twelve paired vessels and names the tendons or fascia accordingly,
such asthat of theTaiyang Vessel of the foot. Like the various qichan
nels, jin has many secondary branches and run on the surface of the
bodywhencomparedwiththefiveorgansandsixviscera.Theyallstart
fromthefingertipsortoesand movealongthearmsor legs,passingover
thebuttocks,alongthespine,andthroughthe neckandhead.Unlikethe
channels,theydonotpenetrateanywherenordotheyhaveanycontact
withtheinnerorgansorareassociatedwiththepassageofqi.Disorders
inthe jinareusually dueto coldorheat;themainsymptomisusually jin
strain, pullingpain,cramps,orspasms.
To avoid confusion I translate jin as tendon and indicate when
usedotherwise.Keepinginmindtheinherentinsecurityandambiguity
oftheterm,therenditionancestraltendonispreliminary.What,then,
isitandwhereisitlocated?TheSuwenhasitinthesexualorgan:Ante
rior yin is where the ancestral tendon gathers. This [is also] where the
Taiyin [spleen]andtheYangming[stomach]vesselsunite(45.1).Wang
Bingcomments:
130 / Chapter Eight
Therefore, the ancestral tendon descends along both sides of the navel and
joins in the sexual organs. Therefore the text speaks of anterior yin. The
Taiyin[Vessel]isthespleenandtheYangming,thestomach.Theyallattach
closely totheancestraltendon.ThereforethetextsayswheretheTaiyinand
Yangmingunite.
MaShithinksthattheancestraltendonistheuprightlineofmuscle
aboveandbelowthehorizontalbone,i.e.,thepubicboneunderneath
the pubic hair. Zhang Jiebin notes that it is where all the tendons
gather.Headdsthatthetendonvesselsofthethreeyinchannelsofthe
foot as well as the three main extraordinary vessels all gather there
which is why it iscalledancestral tendon (Leijing15.34).Guo Aichun
agreesandsays:[Accordingtothe]Jiayijing,zong[ancestral]shouldbe
zhong [all]. He reads the passage as the area of the sexual organs is
whereallthetendonsmeet.
WuKuncallstheancestraltendonthebigtendoninthemiddleof
thebody;ZhangZhicongsaysthatit isthesexualorgans. MaShicon
tradicts this and notes that if ancestral tendon indicated the sexual or
gans, then thetextshould actually spell thisout.Indeed,there arepas
sagesintheSuwenwhichnotethatthesexualorganiswheretheances
traltendon gathers.Thisisnotthesameasequatingitwith thesexual
organs.
Damage or deterioration of the ancestral tendon is a symptom of
disease. In one passage it speaks of incessant thinking, limitless yearn
ings, and especially excessive sex as reasons why the ancestral tendon
weakens and becomes flaccid leading to the occurrence of white dis
charge (44.2). Wang Bing comments that this discharge in men is like
semen in consistency and flows like urine; in women it flows from the
vaginalikesmoothsatin.YangShangshanintheTaisumakesasimilar
comment:
Enteringthebedchamberexcessivelywillleadtotheslackeningandrelaxing
of the sexual organs. They are the foundation of all the tendons. When the
ancestraltendonisinjured,tendonswillbecomeflaccid.Inwoman,awhite
dischargeoccurs.
WangBingandYangShangshandiffer.WangBingbelievesthat the
symptoms of a slackenedancestral tendon affectbothmaleandfemale,

whereasYang Shangshanthinks it islimited to women. Thediscussion
thentouchesontheroleof ancestraltendoninthetreatmentof flaccidity:
The Yangming [Vessel]isthe oceanof thefive organs andsix viscera. It is
responsibleformoisteningtheancestraltendon,whichinturnisresponsible
forholdingthebones[together]andfacilitatingthejointmechanism.(44.3)
Yang Shangshan reads the last section as the ancestral tendon

bindsboneandfleshtogether,indicatingthatjinmeanstendonsrather
thanmuscles.WangBinggoesontoexplainthefunctionoftheancestral
tendonbydetailingallthemusclesconnectedtoit:
Theancestraltendonistheuprighttendonaboveandbelowthehorizontal
[pubic] bone, located underneath the pubic hair. It ascendsto link up with
chest and abdomen, descends to penetrate the hipbone and coccyx. It also
runsfromthebackandabdomen uptotheheadandbrow.Thus,itissaid
thattheancestraltendonisresponsibleforholdingthebones[together]and
for facilitating the joint mechanism. In other words, the torso becomes the
bodysbigjointsection.Forthisreasonitcontrolsallbendingandstretching
andwespeakof release andlock.
RodoPfisterconcludesthatWangBingseestheancestraltendonas
partofagreatercomplexofabdominalmuscles,i.e.,thepyramidalmus
cles, those of the pelvic diaphragm, and of the urogenital diaphragm
(2011,I:2.3.2).Thismaybeso,butthereisstillnoconsensusonitsexact
location.
How, then, does it connect with the extraordinary vessels? What
happenswhenitdoesnotfunctionoptimally?Tobegin,theSuwenmen
tions that the Penetrating Vessel is responsible for irrigating allthe dif
ferentmusclesandfasciaofthebody.ItjoinswiththeYangmingVessel
attheancestraltendonwhichiswhereallyinandyang[vessels]unite
(44. 3). The etiology suggests that the ancestral tendon is a structure or
tissuethathastensilequalitiesandabondingfunction.Anypathological
factorsthatcausetheYangmingVesseltobeexhaustedleadtoitsslack
ening.Thisinturncausesflaccidityinthelegsandtheinabilitytowalk.
Since the ancestral tendon is further associated with the sexual organs,
itsoptimalfunctioningisalsocrucialtothedevelopmentofsexualchar
acteristics.
The Lingshu describes the consequences of damaging the ancestral
tendon in men.Why is it that a man who has suffered an injury tohis
132 / Chapter Eight

sexual organs and can no longer achieve an erection can still grow a
beard, while eunuchs will not be able to do so? The Lingshu answers:
Whenaeunuchhashisancestraltendonremoved,hisPenetratingVes
selisinjured.Thebloodthatisdischargedcannotberecovered,hisskin
knitsinward,hislipsandmoutharenolongernourished.Therefore,he
cannotgrowabeard (65.2.1).
Why, then, is it that a natural [born] eunuch, who has suffered
neither severanceoftheancestraltendonorlostalargeamountofblood,
cannotgrowabeard?Thisisbecausehedoesnothavesufficientnatu
ral[heavenly qi], his ConceptionandPenetratingVesselsarenotfull,and
hisancestraltendon isnotdeveloped.Thereisqibutnoblood,thushis
lips and mouth cannot be nourished and he cannot grow a beard
(65.2.1).
Thesetwopassagesindicatethattheancestraltendonisresponsible
forthedevelopmentofmalesecondarysexualcharacteristics, suchasthe
growth of a beard. When the ancestral tendon is not well developed at
birth or damaged (e.g., through castration), the flow of blood and qi is
interruptedwhichleadstolackofenergeticsupportoflipsandmouth. 7
This means that the ancestral tendon must be closely connected to the
urogenital complex.
The Lingshu also shows that the vessels and tendons have various
correspondingvessels,whicharecloselyrelatedtothesexualorgan.This
holdstrueforallthemajorqichannelsofthefoot(ch.13).Anydisorder
in the tendons causespain and spasms in the inner flank of the thighs,
whichinturnleadstotheinabilitytousethesexualorgans.Iftheinjury
isinternal,thentherewillbeerectiledysfunction;ifitisduetocold,the
penis will shrink and withdraw; if it is due to heat, the penis remains
erectanddoesnotsubside,i.e.,detumescence.Similarly,whenthereisa
Endocrinologicallyitindicatesadisruptionofhormonalfunctioning.Sec
ondary sexual characteristics, such as beards, are controlled by hormones. The
removal or damage of the ancestral tendon in man disrupts the production of
sexualhormonesandasaresultnobeardcangrow.Anotherinterestingconse
quence suffered by eunuchs is incontinence. They lose control of their urinary
function, which has led to the description of any unbearable smell as being
stinkyleaking eunuch. It isalsosaidthat eunuchs could be detected bytheir
stench300metersaway(Mitamura1970,38).VanGuliknotesthatalargenum
ber of the eunuchssufferedfrom chronic incontinence ofthe bladder andother
ailments(1961,25556).
7

heatdisorderintheShaoyinorhearttendonofthehand,itslackensand
cannotretract,leadingtothe inabilitytouse thesexualorgan.
From the above passages and commentaries, it seems that the ex
pressionancestraltendonreferstoanareaorastructureinoraround
thesexualorgansofbothmaleandfemale,wherevarioustendons, mus
cles,fascia,andnervescometogether.LikethecoitaltendonintheHe
yinyang,itisthesameasthecoitalvessel[jiaomai ] insidethedark
gate[vagina].Itcanbestimulatedbythepenis,causingbothbodiesto
experienceecstaticexcitement.Herethecoitaltendonsoundslikean
areainthevaginawhere themusclesfascia,andnervescometogether.It
istemptingtoequatecoitaltendontothesocalledelusiveGrfenberg
Spot(Gspot;).8 Forargumentssake,ifthecoitaltendonistheGspot,
then tendonmustindicateagroupofcellsandnotreallyamuscleor
tendon.Ontopofthat,theancestraltendonisalsopartofthemalesex
ualorgans.Therefore,itisdifficulttomaketheassociation.Hence,there
isstillnoconsensusamongscholars onits nature or exact location.
Theancestraltendonmightwellbeanarea,structure,ortissuethat
connectsimportant muscles,fascia,nervesandenergylines.Itcouldalso
be a specific line of tendon or nerve attached to the sex organs, whose
damagesuch as in cases of castration or overuse through excessive
sexual activitycauses a reduction in the tensile strength and leads to
diseases,suchasgenitaldischarge,legparalysis,andincontinence.Then
again,itcouldalsobea chimerical associative complex,somethingthatis
notobjectivelypresentbutfeltproprioceptively.Regardlessofitsconsti
tutionandlocation,whetheritisinamanorawoman,orwhetheritis
physicalorperceptive,anyinjurytothisimportant partinevitably affects
sexualreproduction.
To sum up, sexual and reproductive anatomy, both physical and
abstract,formamajorpartoftheSuwens discussionofsexandsexuality.
ThisshowsthatmedicalmastersevenintheHanexpectedstudentsand
ForthedebateonGSpot,itsexistence,function,androleinfemaleejacu
lation,seeLadas,Whipple,andPerry1982;SyedandOConnel1999;Hines2001;
Pfister2007; 2010,1:3.5.2.
8
134 / Chapter Eight

practitionerstobefamiliarwithanatomy andthefunctioningofallmajor
parts.Beyond this,moreover, theSuwen accordinglyexpects itsreaders
tounderstandnotonlymedicaltheoriesandsexualanatomybutalsothe
specific physiology associatedwithreproduction.
Chapter Nine
Reproductive Physiology
At sixteen, his kidneyqi is abundant his heavenly stock ar
rives his essential qi overflows and he discharges his semen. If
he has sexual intercourse, he can have children.
Suwen
Aswithmostcivilizations,theChineseattempted tolegitimizetheirexis
tencebyestablishingtheiroriginsthroughcreationmyths.Intheancient
cosmologies of Greece, Egypt, Mesopotamia, and others, mythic narra
tivesdescribetheprimevalelementaswater,andinVedicmyth,itisfire
inwater.Incontrast,thebasicprincipleofChinesecosmologyisprimor
dialqi, a cosmicenergy thatgoverns matter,time,andspace.Thisenergy
underwentatransformationatcreation, andits nebulous,vaporous basis
differentiated intothedual elements ofyin andyang,male and female,
hard and soft, and other binary factors as outlined in classic yinyang
cosmology (Birrell1993, 23;Mackenzien.d., 25673).
Itseemsthatthemoreawesomethecreationmyth,themorepower,
credibility, and legitimacy is bestowed on the group. Based on mythic
narratives found in six Chinese classical texts, Anne Birrell names five
maintraditions:
(1) The cosmogonic list that describes the world picture in the
Tianwen (HeavenlyQuestions)chapteroftheChuci,dat
ingfromthe 4th century BCE.
(2) The cosmogonic myth that describes the creation of the uni
verseandhumansoutofformlessmistyqiintheHuainanziof
145BCEandinthe Daoyuan(SourceoftheWay),a recently
excavated mortuary text believed to date from the 4th century
BCE.
135
136 / Chapter Nine

(3) The cosmogonic myth that describes the separation of earth
fromsky andthe origin of the firstborn semidivinehuman in
the Sanhuang wudi shiji (Historical Record of the
Three SovereignsandFiveGods),datedto the3rd century CE.
(4) ThemythofthecosmologicalhumanbodyintheWuyunlinian
ji (AChronicleoftheFiveCyclesofTime),fromthe
3rd century CE.
(5) The myth of the making of human beings by a creatrix in the
Fengsu tongyi (Pervasive Explanations of Common
Customs),fromthelate 2nd century CE.
Thesefivetraditionscontainfourseparateaccountsofhowhumanbe
ingswerecreated(1993,25).Thebestknownamongthemtellshowthe
goddess N Wa kneaded them from yellow earth. Although she
workedfeverishly,shewasunabletofinishhertask.Soshedrewacord
inafurrowinthemudandlifteditouttomakehumanbeings.Thisis
why there is a distinction among people: those wealthy and noble are
handmade from yellow earth, while ordinary, poor commoners are
fromthecordsfurrow(Birrell1993,35).IntheHan,NWawaspaired
with Fu Xi to symbolizemarriage.Acommon image on stonecof
finsinHantombs(seeFinsterbusch2004),thepairisdepictedasjoined
byentwinedserpentinelowerbodies(seeFig.11).
Fig.11:N WaandFuXi.
Reproductive Physiology / 137

Laterdepictions,suchasthosefoundinTangsilkpaintingsintheAurel
Stein Collection (Astana in the National Museum, New Delhi), show
that their legs have been absorbed into their serpentine lower bodies
andhavebecomeevenmoreentwined.
TheearliestdocumentationofChinesecreationmythscanbetraced
backtolateWarringStatesperiod;thelatestappearedinthe3rd century
CE.Thus,itseemsthattheemergenceofthesemythsranparalleltothe
compilationoftheSuwenyetitdoesnotascribethecreationof children
to any myths. On the contrary, the Suwen is dedicated to the empirical
conceptthathumanbeingsaretheproductofthesexualunionbetween
manandwoman.Itspecifiesthat,inordertoproduceoffspring,notonly
opposite sexes (male and female, yin and yang) are required, but they
have to be sexually mature. Sexual maturity for a female means being
abletomenstruate,whichhappensaroundagefourteen,andforamale
to be able to produce semen, which occurs around sixteen. This once
more shows how much the text documents the overall Chinese devel
opment away from mythical and magicospiritistic thinking toward a
new medical,clinical,and protoscientific thinking.
In the beginning of the text, the Yellow Emperor wants to know
whypeoplelosetheabilitytohavechildrenastheygrowolder.Heasks:
Isitduetotheexhaustionoftheirreproductivepotentialorisitaccord
ingtothelawofnature?InresponseQiBooutlinesreproductivephysi
ology andthe fertilitycycleasconnected tothe agingprocess, which is
parallel but different in males and females. He describes in detail how
thebodiesofbothmenandwomengrow,develop,mature,age,andde
clineallinaccordancewithphysiologicalprocesses.
QiBoexplainsthatafemaleoffourteenisabletobearchildrenbe
cause her heavenly stockhas arrived,herConception Vessel ispene
trable, and her Penetrating Vessel is abundantthus her menstruation
arrives on time. Similarly, amale atsixteenhas abundantkidneyqi,his
heavenly stock has arrived,his essential qi overflows, andhe is able to
emit semen,sothathecan haveoffspringas andwhenheharmonizes
with yin(insexualintercourse).Aslongastheystayhealthy,bothwill
remain fertile and productive until well beyond middle age. At forty
nineyears,thewomansConceptionVesselisdepletedandherPenetrat
ing Vessel isweakened,becoming limited in function. Atthispointher
heavenly stock is exhausted and her uterus or earth channel becomes
impassable, which leads to the absence of menstruation. At this stage,
138 / Chapter Nine

herbodyisconsideredflawed,i.e.,unfitforchildbearing,andshecan
nolongerbecomepregnant.
Male reproductive physiology works along similar lines. The kid
neystorestheessencereceivedfromthefiveorgansandsixviscera,and
when they are filled abundantly, he can produce semen to be emitted.
However,atsixtyfour,thestoragecapabilityofthekidneyisweakened,
the heavenly stock is exhausted, and both quality and quantity of es
sence diminish.Hence,heisunableto havechildren.
There are, however, some exceptions to this rule, and the Yellow
Emperorimmediatelywantstoknowwhysomemenandwomenofad
vanced years are still able to have children. Qi Bo replies that they are
peoplewhofollowtheDaoandhavekepttheirbodiesinperfectcondi
tionwiththehelpoflongevitypractices.Thus,althoughadvancedinage,
they canstill produceoffspring.
TheSuwenrepresentsaclearshiftintheunderstandingthathuman
reproduction is an empirical process in which male and female bodies
havetoripen,i.e.,theremustbemenstruationinwomenandejaculative
capability in men, followed by active sexual intercourse (the mixing of
essence),beforeanewspiritpotencyintheformofan individualbeing
can be created. The first condition (menstruation and ejaculation) in
volves visible processes which can be objectively quantified. Medical
practitionersknowthatany menstrual problemaffects fertility.Similarly,
the inability to manage penetration is another visible sign that contrib
utestotheunderstandingof reproductionasanempiricalprocess.
Thisempiricalunderstandingisfurtheraugmentedbyvariousphi
losophical and medical theories, such as the idea of the mixing of es
sences tocreateanew person.Suchtheories alsoinvolvedetails ofsexual
energetics,describingtheexactfunctionofessence,qi,kidney,extraordi
naryvessels,andsooninreproductivephysiology.Themostintriguing
ofthem,howeveris theheavenly stock.
Heavenly Stock
Liketheancestraltendon,theconceptoftheheavenlystock(tiangui
) appears only in the Suwen, where it is central to reproductive
physiology. After its appearance in theSuwen, itdoesnot appearagain
intheliteratureuntilintheQingwhenXiaoXun discussesit incon

junctionwithillnessesrelatingtomenstruationinhisNke jinglun
(Comprehensive Discussion of Womens Medicine; dat. 1684). The
manyreferencesto heavenlystockinotherQingmedicaltextsaremostly
inrelationtowomensdisordersandusuallyreferbacktotheSuwenor
WangBingscommentary.Nonewideasordiscoveriesarefoundthere.
Itremainsapuzzlewhysuchanimportantconceptinhumanphysiology
stayeddormantforsolong.
What, then, does tiangui mean? Tian has been a cosmological and
spiritualaspectofChinesethoughtandreligionsincetimeimmemorial.
Itplaysanessentialroleinsexuality,andsomepositionsevenrefertoit
intheirnames(seeFig.12).
Fig.12. Turningearthandrevertingheaven.
Position#32intheSuepian.
AlreadyWangChong (2797)opposedamoralisticapproachtothe
study of heavenly phenomena (Kalinowski 2004, 258). Together with
other scholars, he deconstructed cosmic orderliness of the ancients and
showedthattian,ratherthanreferringtoadeity,meansnatureorthe
sky. Fung Yulan summarizes these and other studies, and lists five
differentmeaningsof tianinearlyChina:
(1) Amaterialortangibleentitysuchasthesky,seeninopposition
to earth and as the other half of a binary pair; it refers to the
physicaluniverse.
(2) A ruling or presiding figure as in Highest Emperor of
SovereignHeaven(Huangtianshangdi).
(3) Afatalisticideaequivalenttotheconceptofdestiny(ming), over
which humans have no control and which appears in the
Mengzi (1B14).
140 / Chapter Nine

(4) Anaturalistic forcesimilar to the worldofnatureasdescribed
inDiscussiononHeaven inthe Xunzi (ch. 17).
(5) Anethicalor moralprincipleasexemplifiedinthe Zhongyong:
Whatheavenconfersonhumanityiscalledhisnature.(Fung
1952,31)
Tian, then, is both tangible and abstract at the same time. However, in
thecompoundtiangui,the term indicatessomethingmorephysiological
andmedicalandreferstothestatebeforeconception.Itissimilartothe
ideaof astatepriortocreationknownasbeforeheaven(xiantian )
(WangHTetal.1997,1030).Hence,tianintianguirepresentsthecosmo
logical constellation of the universe before the intermingling of essence
creates abeing.
Thewordguimakes upthesecond partof thecompound. It isthe
lastofthetenHeavenlyStems(tiangan ),whicharenamesoftheten
daysoftheweek(xun ),alreadyusedintheShang.TheChinesecom
binedthesewiththetwelveEarthlyBranches(diji),usedtonamethe
months of the year and also the yearsmatching the stations of the
planetJupiterandwellknownastheChinesezodiacintosixtycharac
terpairs and used them to designate years, months, days, and hours.1
The Zhoubi suanjing, portrays the stems and branches as part of the
modelrepresentingheavenandearth,whichtheearlyChineseembraced
astheiruniverse(Cullen1996,4445). JosephNeedhamdescribes thesys
tem astwo enmeshedcogwheels, onehaving twelve andtheotherten
teeth,sothatnotuntilsixtycombinationshavebeenmadewillthecycle
repeat....Thepracticeofusingthemfor[naming]theyearsaswelldid
notcomeinuntiltheendoftheFormerHaninthe1st centuryBCE,but
thenceforwarditsusescontinuedintomoderntimes (1959,39698).
Thecharacterguialso relatestoyininthe yinyangpattern, towater
amongthefivephases,andtothenorthamongthedirections.Theseas
sociationsappearinconjunctionwiththe fivecirculatoryphasesandsix
seasonal influences (wuyun liuqi ). Catherine Despeux has
shown that this principle was still in use as a source of innovation in
medicineundertheSong(9601279) (2001,12169).
1 ForadetaileddiscussionontheChinesecalendar,seeKeightley1999,249
51; Cullen 1996, 710; Zurndorfer 1995, 297309. The eight characters for the
year,month,day,andhourofbirtharestillessentialinfortunetellingtoday.

The Suwen employs gui to name days and years.2 It also describes
the influencesofthesixkindsofweather oneachandeveryiteminthe
sexagenary cycle (71.2.1). There is, therefore, no mystery about gui as
employed in the context of the calendar. However, what does it mean
whencombinedwithtian?
Initsoutlineofthestagesofreproductivephysiologyinbothsexes,
the Suwen uses the tiangui variously. The heavenly stock arrives fully
during puberty (at age fourteen for girls; sixteen for boys) and stops
functioningatthe end of the fertile years (at agefortynine for women;
sixtyfour formen). Thegeneralrule is that whenkidneyqiisabundant,
tiangui arrives;whenkidneyqiisweakened, tiangui is exhausted (1.3).
Wang Bing comments that gui means rengui , which corre
spondstothenorthamongthe directionsand towateramongthephases,
andisalsothenameofanearthlybranch.GuoAichundefinesitaskid
neyqi in males and femalesthe kidney system belonging to the same
cosmologicalcoordinates ofwater,north,etc.YangShangshanstatesthat
tianguiis thesameas essential qi,the inherent energetic function ofthe
kidney system. Zhang Zhicong says that guiwater is produced by
tianyiheavenlyunity.GaoShishiagreesandaddsthatmalesareruled
byessenceandfemalesbyblood.MaShi describestianguiasyinessence.
The scholars of the Shandong andHebei medical schools, finally,com
ment that it is a product of the kidneyqi function but not the same as
kidneyqioryinessence.Allinall,theyagreeonthelinkwiththekidney
systemandwithessence.Butwhatisit,really?
Among Western scholars, Claude Larre translates it as fertility
(1994, 59), Henry Lu as sex energy (1978, 4), Nguyen Van Nghi as
sexualmaturity(1996,36),CharlotteFurthaspuberty(1999,46n20),
RobertvanGulik asthetermordainedby heaven(1961, 16), and Ilza
Veithasmenstruation(1966,100n8).Themostplausibleinterpretation
is by Nelson and Andrew Wu, who say that it is the substance neces
sary for the promotion of the growth, development, and reproductive
functionofthehumanbody(1997,9)whichiswhyIcallitheavenly
stock.Isee itasa fixedquantum ofconcentratedreservebestowedby
heavenornaturecalledintouseasandwhenthebodyrequiresitforthe
purposeofgrowth, sexual development,andreproductivefunction.
2 The word appearsto denote days in18.3.4, 22.1,22.2.1, 22.2.2(2x),22.2.3
(2x),22.2.5,23.1(3x);todenoteyearsin42.1.2,67.1(e.g. ).
142 / Chapter Nine

AccordingtotheSuwen,heavenlystockispresentinbothmenand
women. It arrives at puberty, when kidneyqi is abundant and indi
catessomekindofenergyorsubstancethatpromotesgrowth,develop
ment,andreproductivephysiology.Itmaintainsmenstruationandpreg
nancyinwomanandallowsmentofatherchildren.Abundantfrompu
berty through maturity, it starts to decline in middle agethe mid
thirtiesforwomen,thefortiesformen.Whenitisexhausted,menstrua
tionceasesinwomen,whichsignifiestheendofherreproductivelife.In
mentheamountofsemenproduceddeclines,andhischancesofproduc
ingoffspringarereduced.
Reproductive Hormones
Heavenly stock cannot, therefore,be simply kidneyqi or essential qi as
the scholars of Shandong and Hebei medical schools note correctly.
Rather,itindicatesthepresenceofsomethingelse,somethingthatfunc
tionsatasubtlerlevel,somethingheavenlyornatural. Alreadyin80CE,
WangChongbelievedthatsuchasubstanceexistedinthehumanbody,
asoutlinedinthe discussionof sexreversalinhisLunheng(Balanced
Discussions).
Several substances arepotentialcandidates.TheChinese first used
the humanplacentaformedicalpurposesinthe8th centuryCEandmade
itcommoninthe13th.Inthe16thcentury,urinederivativesknownasau
tumn stone (qiushi)or autumn ice (qiubing)were used. Physi
cianscollected urine in largequantities anddivided itaccording to age
andsex,justlikeasteroidfactorymightdotoday(Needhametal.1983,
28586,310).
Among Western equivalents, reproductive hormones are the fore
mostcandidatefortiangui.Endocrinologyisarelativelyrecentfield,and
the termhormonewascoinedbyErnestH.Starlingin1905inBritain.He
introduced the concept of hormones as powerful substances regulating
processesinthebody,understandingthemaschemicalmessengers,car
riedbythebloodstreamfromtheorganwheretheyareproducedtothe
organwhichtheyaffect.Thecontinuallyrecurringphysiologicalneeds of
thevariousorgans,then,determinehormonalproductionandcirculation
inthebody(Oudshoorn1994,16).

Notuntiltheearly20th centurydidphysiologistsfocusonthesecre
tions of the gonads (testes and ovaries) or hormones as chemical sub
stances. By 1910, the idea of gonads as agents of sexual difference had
given way totheconcept of sexhormones aschemicalmessengers.The
gonadswerethenconsideredtobetheseatofmasculinityandfemininity,
theirsecretionsgivingrisetothegenderizationofthetwosexes:youare
eithermaleorfemale.Thismaybetrueformostpeoplebut,asshownby
Suzanne Kessler (1998) and Alice Dreger (2000), construction of gender
identityismorecomplicatedforsomepeoplesuchastheintersexedand
hermaphrodites.
Theclosestmatchofthe somethingelse theancientChinesecalled
tiangui in terms of biochemical parallels is the gonadotrophinshor
monesthatstimulatecellactivityinthegonadsandareessentialinmale
and female fertility. At puberty, a stage between childhood and adult
hood, secondary sexual characteristics develop, sexual organs mature,
and reproduction becomes possible. In girls, puberty usually starts be
tween the ages of nine to thirteen, when the first menstruation (men
arche)takesplace.Itisusuallycompletebyagefourteentosixteen.Boys
tendtostartpubertyayearorsolater,i.e.,betweentheagesoftenand
fourteen;thefirstejaculationoccursaroundthistime(KlinkeandSilber
nagl1996,44344,488).
Abouttwoyearsbeforetheonsetofmenstruationorthefirstejacu
lation,thehypothalamusbeginstosecreteasubstanceknownasGonad
otrophinReleasingFactor (GRF). It travels to the pituitary gland at the
baseofthebrainandcausestwochemicalsubstancesorhormonestobe
released: the first is called the FollicleStimulating Hormone (FSH), the
second is Luteinising Hormone (LH). Both enter the blood stream and
travelaroundthebodytoactivatetheovariesinthefemaleandthetesti
cles in the male. FSH stimulates the growth of the follicles containing
eggs in the ovaries and the production of estrogens, which helps the
growthofbreastsandgenitalsingirls.Italsotriggerstheproductionand
development of sperm, while LH helps the production of testosterone
(Oudshoorn1994,19).
Heavenly stock and gonadotrophin hormones thus certainly share
similarcharacteristics,butthisdoesnot meanthat theyarethesame.The
difference in interpreting ancient Chinesemedical theories andmodern
biomedicalthinking is that theprimary interest ofbiomedicine is in the
substratum as opposed to function. In other words, heavenly stock, al
144 / Chapter Nine

though linked with an underlying something else, is dominantly de
scribedintermsoffunction,whilesexhormonesareseenassubstances
orsubstratawiththeirownchemicalstructuresandproperties.Assuch,
heavenlystockisaphysiologicalconceptuniquetoChinesemedicine,its
functions formulated within the sphere of theprevailingsystem ofphi
losophicalthoughtsuchasyinyangandthefivephases.
Menstruation
The Mawangdui manuscripts include the Taichan shuspecially on mid
wifery. It containssomeobjectiveobservations,but for themostpart is
entrenched in spiritbased,magicalthinking. TheSuwen,havingmoved
toward empirical analysis, gives a more sober view of womens repro
ductive dynamics but does not have a special chapter or section on it,
rather it discusses female conditions in connection with the etiology of
various ailments or in the presentation ofmedical theories. There is no
fieldofobstetrics and gynecology(fuke ), which does not arise until
theSong(Furth1999,5993).
TheSuwenrecognizesthatmenstruationknownasmonthlyaffair
(yueshi ),moon, or month (yue )is the most important aspect of
womens reproductive dynamics and that any disturbance of the cycle
willaffectfertility(1.3).Itlinksitwithheavenlystock,fertility,andcon
ception.To produce progeny, a woman must menstruate regularly and
intherightamount.Irregularityandabnormalmenstruationaresignsof
pathology.Forexample:Thesicknessofthesecondyang[vessel]devel
ops in the heart and spleen and the woman has no monthly affair
(7.2). WangBingcomments:
Whenthelargeintestineandstomach[vessels]getsick,theheartandspleen
are affected. When the heart is affected, blood does not flow [smoothly];
when the spleen is affected, the flavors [of food] cannot be transformed.
Whenblooddoesnotflow [smoothly],thewomancannotmenstruate.

These are also the same physiopathological conditions that pro
duceamenorrheainTCM.3 Aboutanotherconditioninwhichmenstrua
tionstaysaway,the Suwenstates:
Whenitarrives,[thepatients]qiisdiminishedandshe[feels]hotattimes
Her bodyisheavyand shehasdifficultywalking.Her monthlyaffairwillnot
come. . . This is called windwater and it is discussed in the Chifa [,
RulesofNeedling] (33.4)
WangBingnotesthatthistreatisewaslostbyhistime.Thispassage
referstothesymptomsofapersonsufferingfromkidneywind,inwhich
kidneyqi isdepleted andthere shouldbe noinsertion ofneedles. If the
patient is treated with needles, injurious qi enters the body to cause,
among othersymptoms, amenorrhea.Yang Shangshan addsthat injuri
ousqireferstopathogenicqi;when thisarrives,thewomanwillbesick
(Leijing 31).Absenceofmenstruationisthusasymptomofkidneywind.
Inthesamepassage,QiBoexplains:
When the monthly affair does not come, this is due to obstruction of the
uterusvessel.The uterusvesselisrelatedtotheheartanditconnectsinside
the womb. When qi ascends and presses against the lungs, heartqi cannot
descendsmoothly.Then themonthlyaffairdoesnotcome.(33.4)
The absence of menstruation in this case is caused by blockage of the

vesselintheuterus.Theexpressionthemonthlyaffairdoesnotcome
(yueshibulai )is a general symptom and it doesnot differentiate
betweenprimaryorsecondaryamenorrhea.
In another passage, the Suwen discusses the cause of amenorrhea
and oligomenorrhea (scantiness of discharge) with special reference to
dryness of blood, which affects both men and women. The result of a
combination ofcomplexpathological factors,in women itmanifestsnot
onlyas anabsenceofmenstruationbut alsoas ascantinessofdischarge.
Inbiomedicine,absenceofmensesiscalledamenorrhea,dividedintopri
mary and secondary. Primary amenorrhea occurs when a woman has not had
hermenarche(firstmenstruation)bythetimesheiseighteen;secondaryamenor
rhea occurs when a woman has had periods but they havestopped for at least
threemonths.InTCM,theabsenceofmenstruationiscalledblockedflow(bi
jing ).SeeMaciocia1998,273301.
3
146 / Chapter Nine

Thediseaseiscalleddrynessoftheblood.Itiscontractedatayoungage,
when one has lost a largeamount of blood or entersthe bedchamber often
whileintoxicated.Itleadstoanexhaustionof qi and to injuryoftheliver.The
monthlyaffairwilldeclineornotcomeatall.4 (40.1.2)
Whenlargeamountsofbloodleavethebody,WangBingspeaksof
loss of blood (tuoxue ), indicating a downflow from the uterus
similar to nosebleeds. Wang Bing explains that when one is drunk, the
vessels are abounding with blood which causes the interior to become
hot. If one enters the bedroom and engages in sexual intercourse, the
marrowandotherliquidsflowdownandkidneyqiisdepleted.Sincethe
liverstoresblood,smallerorlargerlossesinjureit.Inmales,thisleadsto
a weakening of the essential fluids (including semen); in females, the
monthly affairdiminishes orfails toarrive.Zhang Jiebin addsthat dry
nessofblood meansthatthepassageofthemonthlywaterisinterrupted
(Leijing 17.63).
Absence of menstruation and scanty discharge are two different
illnesses which go back to earlier injuries. Treatments include sparrow
eggs withblackcuttlefishbones andmadderrootformed intopillsand
taken beforemealswithabalone broth.
From the empirical point of view, the easiest way to ascertain the
cause of infertility is the obvious sign of absence of menstruation.
However, the early Chinese also noted that irregular bleeding and the
amount of discharge affect fertility. As the text has: When yin is de
pletedand yangthrobs, it iscalledcollapse [due tooverflowing](7.3).
Wang Bingcommentsthatasituation when theYangVesselbeatswith
abundanceandtheYinVesselhasinsufficientqicanresultinaninternal
collapsewithbloodflowingdownward.YangShangshandefinesbeng
asdownpourofblood.ThescholarsoftheShandongandHebeimedi
cal schools describe it as profuse and rapid bleeding: forceful like the
collapse of a mountain.5 Zhang Jiebin says: When yin is depleted, it
This refers to two pathological conditions, i.e., oligomenorrhea (scanty
menstruation) and amenorrhea (absence of menstruation). See Maciocia 1998,
21718,273300.
5 Excessivelossofbloodduetoincreaseddischargeduringmenstruationis
calledmenorrhagia.Thereisalsometrorrhagia,whichisbleedingbetweencycles
which may be heavy. In TCM, menorrhagia is called yuejing guoduo
(Maciocia1998,20717).
4

sinksandisinsufficient.Whenyangiscontending,itfloatsupandthere
is surplus. This causes yang repletion and yin depletion and lead to a
state ofinternalcollapsewithlossofblood(Leijing 6.29).
Altogether,thereisthusmuchevidencethattheChinesewerequite
aware of the importanceandrole ofmenstruationboth for fertility and
withinthewomansownbodilysystem.
Pregnancy
AftertheChinesemadetheconnectionbetweentheimportanceofregu
larperiodsandfertilityforthebegettingofprogeny,anyirregularityin
the menses was viewed with alarm and given full attention simply be
causeperpetuatingthefamilylinewassuchanimportantduty.
InthecontextoftheSuwen,havingchildren(youzi )indicates
theabilitytohaveoffspring,usedforbothmenandwomen (see1.3).It
can also mean being with child or pregnant: When the yin [pulse]
beats[vigorously]andisdifferentfromtheyang,itiscalledbeingwith
child(7.3;71.3.3).Wang Bingcommentsthat yin is said tobe within
thefootlength[chi]andbeatingaloneinthehand.Whenthe[pulse]at
thefootlengthbeatsdifferentlyfromthatoftheinchopening;theyang
qistandsout:thatisasignofpregnancy.Thisishow aSuwenphysician
determinedthat awomanwaspregnant.
AmongthebookslistedonthebedchamberartsintheHanshu,one
text has thetitle Sanjianeifangyouzifang (Prescriptions of
theThreeSchoolsfortheInnerChamberforBegettingProgeny).Itislost
nowbutcouldwellhavebeenthefirstChinesebookoneugenics.
Anothertermforapregnantwoman isheavyinbody(zhongshen
).Forexample: Whenawomanisheavyinbody and loseshervoice
intheninthmonthwhatisthecauseofthis?(47.1.1).WangBingnotes
thatzhong(heavy)canalsobepronouncedchong (insect)andthusin
dicatethatthereis[another]bodyinsideher:sheispregnant.Duringthe
gestation period of ten lunar months, the Shaoyin Vessel of the foot is
key to nourishingthe fetus. If itsqiflow is interrupted,themother will
losehervoiceandcannotspeak.ZhangJiebin addsthatatninthmonth
ofpregnancy,thefetusisatitsbiggestandcanobstructtheqi flowinthe
collateral networkvessel of theuterus(Leijing 17.62).
148 / Chapter Nine

YangShangshanintheChapteronMiscellaneousDiseasesofthe
Taisu says:
Whenthe primary and network vessels ofthe uterus are obstructed. . . be
causethesecondaryvesseloftheuterusisconnectedtotheShaoyin[kidney]
Vessel, which runs through the kidney and connects to the root of the
tongue... theremaybetheinabilitytospeak. (ch.31)
TheSuwenalsodiscussesthisloss ofvoiceduring theninthmonth

of pregnancy (47.1.1). The Lingshu confirms the affliction and explains
that the kidney vessel starts from the popliteal fossa, ascends along the
legs, runs through the torso, and connects to the root of the tongue
(11.1.2,10.2.8).Itspathtakesitpasttheuterusandasthefetusgrows,it
mayput pressure on it that cause obstructions. Since it is connected to
the root ofthetongue, itcan affect the ability to speak.TheSuwencon
siders this an abnormal disease but says that no treatment is necessary
because after the pregnancy ends the ability to speak will return natu
rally. Anothercondition involvesinwarddissipationthatcauses reces
sionandwillleadtomutenessandlameness;thisiscalledkidneydeple
tion (49.1).Thesame connectionofkidneyandtongueisalsofoundina
conditionwhere thepatientlovestospeak(48.2).
Another common term is pregnant (yun ): When there are
pathological changes in the Governing Vessel . . . in women, they may
notbeabletogetpregnant(buyun )andsufferfromdysuria,hemor
rhoids, incontinence, and a dry throat (60.1.3). Wang Bing comments
that the reason for this is that the Penetrating and Conception Vessels
start together from the lower abdomen and ascend to the throat. Also,
theGoverningVesselgoesalongthesexualorgansandmeetstheothers
attheperineum.Thisiswhy thewomancannotgetpregnant.Pathogenic
changes in the Governing Vessel cause the qi to rush upward from the
lowerabdomentotheheartandcausepain.Thepatientwillhavediffi
culty in urination and defecation. This will cause the surging protru
sioninmenandtheinabilitytogetpregnantinwomen.Anotheruse
ofthewordyunistodescribetheembryoorfetus:[Undersuchcondi
tions] thepeoplefeel wretched and sorrowful.Whencold wind is at its
utmost; for thosewhoopposeit, theembryowilldie(71.1.2).
Yet another term for pregnancy is carrying a child (renzi ):
When the [pulse of the] Shaoyin Vessel of the hand in a woman pul
sates violently, she is carrying a child (18.3.6). Wang Bing states that

according to Quan Yuanqis commentary, it should be the Shaoyin
[kidney]Vesselofthefootandnotofthehand[heart].Thelattercanbe
feltwiththelittlefingerinthefoldofthepalm.YangShangshannotes
that this vessel rules the blood (Taisu 15). When a woman is pregnant,
her monthly blood is obstructed and cannot flow. Hence, the Shaoyin
Vesselofthehandisinwardlyreplete,whichcausesitspulsation.Inany
case,agoodphysicianshouldbeabletodeterminewhetherawomanis
pregnantbyfeelingthemovementsinherpulse.
Similarly,the Maijing says:
Accordingtotheclassics,beatingyinanddistinctyangindicatethatsheis
carryingachild....IftheShaoyinVesselofthehandhasapulsethatstirs
inbigmovements,pregnancyisindicated.Shaoyinisthepulseoftheheart.
Theheartgovernsthebloodvessels.Inaddition,thekidneysarenamedthe
uterine gate and infants door. The pulse in the footlength is that of the
kidneys. If thepulse in thefootlength does not yield under pressure, it
shouldindicatepregnancy. (Maijing 1997,319).
This compares to the Suwen, which states that when the yin [pulse]
beats [vigorously] and is different from theyang, it iscalledbeing with
child(7.3).
Another way a physician is able to determine whether a pregnant
woman is about to give birth is by pulse diagnosis. The Suwen states:
The Yellow Emperor asked: How does one know that a pregnant
womanisabouttogivebirth?QiBoreplied:Thebodyhassicknessbut
thereisno injurious pulse[movement](40.1.6).
Another aspect ofcareduringpregnancyispossibleby optimizing
conditionsfor thefetus. TheSuwensays:
Thenameofthediseaseisfetalsickness.Itiscontractedwhen[thefetus]is
still in the mothers abdomen and the mother has a great fright, which
causestheqitoascendbutnotdescend.Itresidestogetherwithessentialqi
andthechildwilldevelop peakillness. (47.1.9)
ZhangJiebinaddsthatwhenachildisbornwithepilepsy,people
nowadays call it fetal sickness (Leijing15.65). Fetal sickness is consid
ered a rather uncommon condition, caused by a sudden scare to the
mother, so that qirisesbut doesnotcomedown again. Thismay cause
confusion in the fetus and lead to epilepsy after the child is born. The
Suwenalsonotesthatpregnantwomenputtheirhealthatriskbygiving
150 / Chapter Nine

in to excessive sorrowone of the five emotional pathogenic factors
(44.2,71.1.2).
The Suwen deals extensively with womens health; especially as it
pertainstofertilityandtheproductionofhealthyoffspring bylookingin
detailsoftheconditionsofreproductivephysiologyandpregnancy.This
matchesclassicalinterests,determinedbythe socialand religiousclimate
ofthetime, dominatedasitwas byConfucianthought. Itwasonlyinthe
Songthat itsinterestand knowledge developed intothe separatemedi
cal facultiesofgynecology and obstetrics. Despite the latedevelopment
in women health care,the study and development of sex and sexuality
havecontinuedbothintherealmof longevity andmedicine.
Chapter Ten
Overindulgence and Intoxication
The people of today do not live according to nature they drink
alcohol as if rice soup they employ recklessness in regular ac
tivities they enter the bedchamber in an intoxicated state and
they allow their lust to exhaust their essence. Hence, they reach
only half a hundred years and are decrepit.
Suwen
The most frequently cited doctrine that links health andsexual cultiva
tionsincethediscoveriesoftheMawangduimanuscriptsisencapsulated
in the seven ways of diminishing and eight procedures of increasing
[qi](qisun bayi).1 Before then, these proceduresmentioned briefly in
theSuwenwereinterpretedvariously.Forexample,WangBingassoci
atesthemwithgrowthanddevelopmentinsevenandeightyearphases
of the female andmale respectively (1.3). Hebelievesthatthe female is
injuredbymenstruation whilethemalebenefitsfromthematurationof
hisseminalessence.YangShangshanbelievesthattheexpressionseven
waysofdiminishingreferstothesevenfolddepletionsyndromecaused
byyangpredominance, whilethephraseeightincreasesindicatesthe
eightfold repletion syndrome caused by yin predominance. For Zhang
Jiebin,sevenbeinganunevennumbermeansthatitisyang,whileeight
asanevennumberisyin;diminishingandincreasereferto thewan
ingand waxing ofyin andyang.Othercommentatorsalsohaveplausi
ble interpretations, but they were all superseded after the Tianxia was
unearthedatMawangdui.Fromthelatter,itisclearthatthesetrefersto
specificareas ofthebedchamberarts among longevity practices.
1 For a general discussion of the methods in the Mawangdui corpus, see

Wile1992,81;Harper1998,42830;Pfister2003,2123;ShandongandHebei1995,
8485n5;Xin1994.
151
152 / Chapter Ten
Procedures for Enhancement

The Tianxia describes in detail how incorrect sexual practices cause the
sevenwaysofdiminishingqi, butamancanpreventthemfromhappen
ing or use theeightproceduresof increasingqitomake up for them. It
says:
There are eight waysto increaseqiandsevenofdiminishing it. Ifone does
notapplytheeightproceduresofincreasingandfailstoeliminatetheseven
waysofdiminishingit,atagefortyyinqi[sexualenergy]willbereducedto
half, at fifty daily activities [mobility]are weakened, at sixty ears and eyes
willnot besharpandclear,atseventythelowerbodyisdryandtheupper
bodydepressed.Atthispoint onecannot usetheyinqianylongerandsuf
fersfromtheflowofsnotandtears.
There are, however, waysto restorestrength: by eliminating theseven
activitiesthatdiminishqi toshakeoffdiseases,andbyusingtheeightproce
dures ofincreasingqitodoubleit.This iswhysomeoldpeoplecanrestore
theirstrength,andthosewhoarestrongalreadywillnotbe weakened....In
other words, the correct application of the procedures of increasing qi and
thecompleteeliminationofthesevenactivitiesthatdiminishitwillprevent
thefive[kinds]ofdiseases.
Accordingtothe Tianxia,theeight procedurestoincreaseqiinclude:

1) regulating qi ; 2) stimulating [the production] of froth ; 3)
knowingtherighttiming ;4)hoardingqi ;5)harmonizingfroth
;6)amassingqi ;7)waitingfortheoverflow ;and8)relax
inginto collapse . Thetextspecifies:
1)Atsunrise,situp,straightenthespine,open thebuttocks,contractthe
anus,andpush down:thisisregulatingqi.
2) While eating and drinking, relax the buttocks, straighten the spine,
contracttheanus,andallowqitopassthrough:thisisstimulating[thepro
duction]of froth.
3) Begin withforeplayand then move on to pleasure; first link the de
sires, thenuse[thepenis]:thisisknowingtherighttiming.
4) Use [the penis] but relax the spine, contract the anus, and press it
down,enteringandexitinginharmoniousregularity:thisishoardingqi.
5)Use[thepenis]but donotmoveinhasteorwithspeed:this is har
monizingfroth.
Overindulgence and Intoxication / 153

6)Afterwithdrawing,allowsomeonetomakeiterect[again],sothatit
is[repeatedly] arousedandagain subsides:thisisamassingqi.
7)When concluding, keep the inner spine still, absorb qi, push down,
andcalmthebodyinastateofwaiting:thisiswaitingfortheoverflow.
8) After completing [intercourse], wash the penis and if it becomes
aroused [again],restit:thisisrelaxingintocollapse.
In other words, these eight techniques enhance a mans physical

healthbyconsciouslyguidingandenhancingqiwiththehelpofvarious
physicalmoves.Theyteachhowtoregulateqiindailylife.Duringinter
course, he needs to recognize the right timing, i.e., make sure that the
penis is properly aroused before intromission. He should thrust regu
larly to keep the qi strong and conclude the session by absorbing it.
There is no mention of ejaculation, but the text speaks of washing the
penisafterconcludingthesexualact.Shoulditbearousedorangered
againafterwithdrawal,it should berested (Umekawa2003,9).
Inaddition,thetechniquesimplyageneralknowledgeofhowqiis
generated,regulated,absorbed,circulated,andstored.Theycloselycon
nect to nonsexual methods of guiding and enhancing qi, such as those
firstoutlinedinaninscriptiononadodecagonaljadeblockoftheZhou
dynastythatdatesfromthe4th centuryBCE.Theoriginalfunctionofthe
blockremains uncertain (Chen 1982),but the inscription has been stud
iedby several scholars (seeWilhelm 1948;Engelhardt 1996,19; Li 1993,
32023;Roth1999;Kohn2008).Itreads:
To guide the qi, allow it to enter deeply [by inhaling] and collect it [in the
mouth]. As it collects, it will expand. Once expanded, it will sink down.
When it sinks down, it comes to rest. After it has come to rest, it becomes
stable.
When the qi is stable, it begins to sprout. From sprouting, it begins to
grow.Asitgrows,itcanbepulledbackupward.Whenitispulledupward,
itreachesthecrownofthehead.
Itthentouchesaboveatthecrownoftheheadandbelowatthebaseof
thespine.Whopracticeslikethiswillattainlonglife.Whoevergoesagainst
thiswilldie.(Harper1998,126)
Thisdescribesafundamentalqi practicecommonlyundertakenaspartof
longevitytechniquesintheHananddominantinbothhealingexercises
and Daoist meditation from the middleages onward. People inhale
deeply, allow the breath to enter both the chest and the mouth, and in
154 / Chapter Ten

thelattermixitwithsaliva,anotherpotentformofqiinthebody.Mov
ing their tongue around their mouth, they gather the saliva and gain a
senseoffullness,thenswallow,allowingtheqitosinkdown.Theyfeelit
moving deep into their abdomen, where they let it settle in the central
areaofgravity,knowninChinesemedicineastheOceanof Qi(qihai )
andinDaoismasthecinnabarfield(dantian ).Theretheqirestsand
becomes stable (Kohn 2008, 14). The eight techniques, therefore,clearly
adopt this fundamental method of qiguiding in the context of sexual
practices,utilizinga powerfulformof energyinthebody.
A later recordof the eightproceduresto increase qiappearsin the
Ishinp inacitationof theYufangmijue.Heretheyaremuchmoregeneral
and, without having more detailed specifications, seem to refer to gen
eralmethodsofnourishinglife.Theyinclude:1)firmingessence(gujing
);2)calmingqi(anqi);3)supportingtheorgans(lizang);4)
strengtheningthe bones(qianggu ); 5)regulatingthepulse(tiaomai
);6)amassing/storingblood(chuxue);7)increasingfluids(yiye
);and8)adjustingthebody(daoti)(seeHarper1998,428n1;Hsia
et al. 1986, 18687). All eight may be achieved with the help of sexual
practices,butcouldalsobeworkedonwiththehelpofphysicalexercises,
meditations,ordiets.
What to Avoid
After outlining what best to do, the Tianxia also spells out the seven
waysofdiminishingqi,whichshouldbeavoidedto preventlossofvigor
anddisease.Theyincludeobstruction(bi ),leakage(xie )exhaustion
(ke ), incapacity (wu ), vexation (fan ), interruption (jue ), and
wastage(fei )ofqi. Morespecifically,theyoccurinthefollowingsitua
tions:
Experiencingpainwhileusing[thepenis]:thisisinternalobstruction.
Sweatingwhileusing[thepenis]:thisisexternalleakage.
Not stoppingwhileusing[thepenis]:thisisexhaustion.
Feelinggreatdesire[forsex]andbeingunable[tobearoused]:thisisinca
pacity.
Panting and irregularity inthe centerwhile using [thepenis]:this is vexa
tion.
Feelingno desire [forsex]yetforcingittoperform:thisisinterruption.

Gettingsickwhileusing[thepenis]:thisiswastage.
Theseinstructionsonhowandwhentohavesexualintercourseare
simpleandeasytofollow, butifthemandoesnotknowhowtousethem,
he brings imbalance to his qi, which in turn causespremature aging, ill
health,andearlydeath.
The Yangsheng Chapters of the Suwen closely echo the instruc
tions of the Tianxia. Upon the Yellow Emperors question on how yin
andyangareregulated,QiBoreplies:
Onemustknowaboutthesevenwaysofdiminishingandeight procedures
ofincreasing[qi],thenonecanregulateyinandyang.Ifonedoesnotknow
howtoapplythese,onewillsufferfromweaknessofthejointsearlyon.At
age forty, yin [sexual] qi is down to half and daily activities [mobility] are
impaired. At fifty, the body becomes heavy, ears and eyes are no longer
sharpandclear. Atsixty,onesuffersfrom yin flaccidity [erectiledysfunction],
qiisgreatlyweakened,thenineorificesdonotfunctionsmoothly,thelower
bodyisdryandupperbodysunk,andsnotandtearsflowwithoutcontrol.
Inotherwords,thosewhoknowhowtoapplythesetechniqueswillbe
comestrong[andhealthy];thosewhodonotknowthemwillgrowold[be
fore their time].Although people may be ofthe same origin, they may yet
havedifferentlevelsofhealth.Thewiseinvestigatethesimilarities;theigno
rant investigate the differences. Fools are deficient, while wise men are
abundant[in qi].
Abundance[ofqi]meansthattheearsandeyesaresharpandclear,the
body is light andstrong, oldpeopleregaintheirstrength,strong people in
creasetheir vigor.
Thus, follow the sages and practice nonaction, open yourself to joy,
peace, and tranquility. Turn away from desire, pleasure, and the [unruly]
mindandfocusonguardingnothingness.Thenyourlongevitywillbewith
outlimit,justasheavenandearthhavenoend.Thisisthewaythesagecul
tivateshisbody. (5.4.2)
TheSuwendoesnotlistordescribetheproceduresindetailbuthas
matching correspondences with regard to the aging process, warning
againstundertakingsexualintercoursewithoutfollowingtheDaoofsex.
Similar signs of aging for people who fail to practice properly also ap
pearelsewhere(Suwen1.3; Lingshu 54.3).
The seven ways of diminishing qi also appear with similar terms
andcharacteristicsinthe Ishinp.Itliststhemas:1)exhaustionofqi (jueqi
); 2) excess of essence (yijing ); 3) dissipation of the pulse
156 / Chapter Ten

(duomai ); 4) emission of qi (qixie ); 5) exposure of the [bodys]
mechanismandthuscausingrecessionandinjury (jiguanjueshang
);6)thehundredobstructions(baibi);and 7)blood exhaustion
(xueke ) (see Harper1998,428n1; Hsiaet al.1986, 18890).
Likeupperclasspeopleinanyculture, membersof theChineseelite
werevictimsofallkindsofoverindulgenceandsufferedfrommaladies
duetoexcess.TheSuwenwarnsconsistentlythatintemperatesexualbe
havior either by itself or in conjunction with alcohol causes numerous
healthproblemsinbothsexes.ThisissupportedbyChunyuYismedical
cases,whichindicatethatexcessivesexualactivitywasacommoncause
of illness in Han China. However, sex together with alcohol wasbyfar
the most common misbehavior to ruin health and cause disease. Both
menandwomenindulgedinthisvice.Asaresult,oneofthemostcom
monproblemswassexualdysfunction,sufferedbymalesaserectiledys
functionand byfemalesintheformof fertility problems.
Alcohol and Intoxication

Inmanyancientcultures,alcoholwasastimulantandaphrodisiac.Asa
braindepressant,itcanaffectsexualperformanceifconsumedinlarger
quantities.Acertain amountwhichvariesfrompersontopersoncan
reduceanxietyandinhibitions,makingiteasierforashypersontomake
socialandsexualcontacts(WagnerandJensen1989,8186).Chinesepo
etsthroughouthistoryhaveeulogizedtheelatedandeuphoricstatesin
ducedbyalcohol.Intemperatedrinking,ontheotherhand,isknownto
have produced recklessbehavior.
Both the ancient Chinese and modern biomedicine recognize that
copiousconsumptionofalcoholicbeveragestothepointofdrunkenness
notonlycausesapersontolosecontrolofsexualabilitybutalsocreates
allkindsofhealthproblems.Anearlyreferenceontheevilsofalcohol
in ancientChina isrecorded in the Shujing: The Duke of Zhou once in
structedthekingonhowtopersuadehispeopletostopdrinkingbycit
ingKingWen,whoforbadealcoholconsumptioneverywhereandatall
times, exceptduring state ancestral sacrifices.The Duke added that the
lastShangkinglosthisempireandthesupportofheavenduetoexces
sivedrinking(Jiuguo 13337; LuX1998,103).

Alcoholic drinks in China are called by the generic word jiu ,
which in the Han referred primarily to a brew made from fermented
grain with added yeast,close tomodernbeer(Sterckx 2005, 35).How
ever, it isnot really beer, either, since itdoesnot involvehopsormalt,
butwasmadefromallkindsofgrain,includingrice,wheat,andmillet,
withafermentingadditivemadefromcookedgrainandknownasqu,
variouslytranslatedasbarm,leaven,yeast,andstarter(Huang
2000, 154). In contrast, wine made from grapes and other fruits, which
was known in the Westsince antiquity arrived inChina from Ferghana
undertheHanbutdidnotplayasignificantroleuntilrecently,itslocal
productionessentiallyamodernphenomenon(Huang2000,23940).
ThesocialroleofjiubeingclosetowineinWesternsocieties,how
ever,thetranslationwineisnotcompletelyinappropriate(Huang2000,
150).Tocomplicatemattersevenfurther,intextsofthemiddleages,jiu
might also indicate hard liquor, again made from various fermented
grains but with a much higher alcohol content.2 Archaeologists confirm
that the Shang people already possessed considerable experience to
make alcohol with the cultivation of agricultural products. When they
haveharvested enough grain, the excess arestored in granaries.Apor
tion of this excess grain was used to brew alcohol and before long a
flourishingalcoholindustrycameintoexistence.Overtime,alcoholpro
ductionbecameanessentialpartoftheeconomy(Qin1989,325).
Alcoholic beverages have held a dominant position in the drink
and food(yinshi )combinationthrough thecenturies (Huang 2002,
149).Thedrinkingofalcoholicbeverages(yinjiu ) bytheChineseup
per classes was a standard social feature, important also for sacrificial
rituals. TheimportanceofalcoholinthelivesoftheancientChinesecan
be gauged by the personnel of a royal household in Zhou China. In a
typicalroyalhousehold,2,263outofthe4,133(i.e.,55%)ofofficerswere
involvedinthepreparationoffoodanddrink.Includedamongtheper
sonnel in charge of food and drink are 110 regulators of alcohol (jiu
zheng )inchargeof340winemakers(jiuren ),whowereusually
women(Hinsch2002,66;Knechtges2002,XIII,45;Zhouli1.1921).There
were also 170 fermenters (jiangren ), who produced fermented fruit
beverages, likecider, slightlysourand withlowalcoholcontent.
2 OnthehistoryofalcoholinChina,seeHuang2002,14968.Onitsorigin,
seeLiHR1995;Y1977,69;Anderson1988,12021.
158 / Chapter Ten

Archaeological finds of bronze vessels for drinking and the ritual
offering of alcohol in brewery remains along with remnants of yeast
thereinconfirmtheimportanceofalcoholinthelivesoftheancientChi
nese (Qin 1989, 32425). The majority of the bronze vessels found from
theShangandZhouperiodsaremadeeitherforbrewing,storage,orrit
ualpresentation.3 TheLijidocumentstheuseofalcoholinreligiousritu
als, whilemany preimperial texts on society and customs describe the
consumption of huge amount of alcohol on social occasions. Michael
FishlensummarizestheuseofalcoholintheShijing,notingthatitserved
as a means to formalize bonds of brotherhood, political alliances, and
more broadly, community relations. In other contexts it can reflect a
senseofwellbeingandcanbeasociallubricant,whichiftakentoexcess,
leadtomoraldecay(1994,26264).
An early source detailing alcohol problems is the Shijing where a
hostess complains aboutherdrunkenguests:
When theguestsaredrunk, theyhowlandbawl,
Upsetmybasketanddishes, cutcapers,lilt, andlurch,
Forwhenpeoplearedrunk,theydonotknowwhatblundersthey
commit. (Legge1893,2223)
Alcohol also plays an important role in Confucianism, and Confu

ciushimselfissaidtohavebeenfondofhisdrink.ButsincetheConfu
cianteachingscall forrespectability andharmony inthe social environ
ment, drunkenness in public or at home was frowned on (Oldstone
Moore2003,17071).
What, then, is the limit of consumption? How do the Chinese de
scribe the state of being drunk? The main word use is zui , intoxi
cated,whichisbasicallyclosetowhatWebsterscallsbeinginacondi
tion caused by alcoholic drink in which control of the faculties is im
paired and inhibitions are broken and in the later stages in which one
tends toward or reaches insensibility (1993, 696). But it goes also be
yondthis. AccordingtoJamesLiu,
[Zui] carries rather different implications and associations. The word does
notimplygrosssensualenjoyment,nordoesitsuggesthilarityandconvivi
3 ForvesselsrelatingtoalcoholseeQin1989;MaCY1986,193201;Rawson
2003,7694.Forsacrificialdrinks,seeArmstrong1998,3754.

ality,asdomanyEuropeandrinkingsongs.Thecharacterconsistsofapicto
gramforawinejarandaphonetictsu[zu],whichbyitselfmeansfinish
or reach the limit. According to the Shuowenjiezi, a philological work of
aboutA.D.100andthecornerstoneofChineseetymology,thephonetichere
issignificant,andthewholecompositecharacterexplainedasmeaningone
reachingthelimitofhiscapacitywithoutoffendingpropriety.Evenifwedo
notacceptthisexplanation,itstillremainstruethatinpoetrytsuei[zui]does
not mean quite the same thing as drunk, intoxicated, orinebriated, but
rather means being mentally carried away from ones normal preoccupa
tions....Itherefore,prefernottouseanythesewordsbuttotranslatetsuei
as rapt with wine. . . Being tsuei in Chinese poetry is largely a matter of
convention.(1962,5859)
The zui of Chinese poets is a state in which the drinkers have

reachedtheirlimitbutwithoutlosingcontrol.Iassociateitwithastateof
slighteuphoria,likebeingtipsy,inwhichthementalstateoftheperson
is slightly alteredbutnotquite to the extentof losing hisorher senses.
However, in the Suwen, zui is usually described as a state of complete
intoxication in which the affected person has no control of his actions.
Forexample,oneentersthebedchamberinanintoxicatedstateandal
lowsoneslusttoexhausttheessence(1.1).Thisindicatesthattheper
son has lost control of his or her emotions and cannot contain his lust.
Thislossofcontrol,moreover,turnssexualintercourseintosuchadan
gerousendeavor.
Therefore,thepoeticstateofdrunkennessandthemedicalintoxica
tion during sex are two different states. This difference is enhanced by
theperceptionofthewriters.Poetsusuallypraisetheirpersonalstateof
beingraptinwinewhereasphysicianstalkaboutthedrunkenstateof
others. The early stages of being drunk, i.e., tipsy, corresponds to the
poeticraptureandassuchisnotabadstate;intoxicationduringsex,on
the other hand, is highly detrimental. The Suwen accordingly speaks of
twocaseswherethepersonisinastateofextremeintoxication(dazui
52.3; dayin;3.3.2).
Alcoholisamongthe120drugsintheShennongbencaojing
(The Divine Farmers Pharmacopoeia) and it is commonly used as a
160 / Chapter Ten

medium for medicinal tinctures.4 In Chinese dietetics, alcoholic drinks
are generally considered tobenonpoisonousandcanbe usedtocure
diseasesifconsumedintherightdoses.Thefirstindicationthatalcohol
wasusedmedicinally(yaojiu )appearedintheWesternZhou(1122
770 BCE), when it was part of the diet prescribed by physicians in the
royalhouseholdtoenhancehealthandcurediseases.
Ofthe 25 casestreatedby ChunyuYi,twoinvolvemedicinal alcohol.
In the first, he used it to treat the King of Jibei for wind inversion and
fullness in thechest;the kingtook itforthreedays and wascured(#9).
The second case concerns Concubine Pin of King Cao Chuan who had
difficultygivingbirth;she tooit andhadasuccessfuldelivery(#14).
Therearesevenformulasforthepreparationofmedicinalalcoholin
theYangsheng fangandoneintheZaliaofang (MiscellaneousHeal
ingRecipes).TheShiwenmentionsalcoholaspartofacure:KingWeiof
Qi(r.357320BCE)asks WenZhi,aphysicianfromthestateofSong,
whatheshouldeattogotosleep,awordthatcouldindicateinsomnia
or a deficiency in sexual energy. Physician Wen suggests pure alcohol
andclumpedchives(jiu ) ,ayangplanttakentoimprovesexualpo
tency.5 Whenthekingaskswhythealcohol,WenZhisays:Alcoholisa
form of essential qi; when it enters the middle, it disperses and flows;
whenitenterstheinside,itpenetratesandcirculates...Thus,weuseit
[asthemedium] for thehundreddrugs (#9).
TheearlyChineseknewaboutthehealingpropertiesofalcoholand
used it for making medicinal decocts with all kinds of materia medica.
AccordingtotheTaichanshu,couplesseekingtohaveachildareadvised
touseaplantcalledjiuzong tomakeamedicinalalcoholanddrink
4 Li Shizhen lists three categories of alcohol in Bencao gangmu 25: normal

alcoholic drinks (jiu)(2524), distilledspirits(shaojiu,) (2525), and wine
fromgrapes(putaojiu )(2526).SeeLuo2003,IV:243855.
5 The reading clumped goes back toHarper(1998, 406n6).The botanical
name for jiuis Alliumtuberosum(Zhang YJ et al. 1994, 1186); it is commonly
knownasChinesechivesorgarlicchives.Itsseeds,roots,andleavescanbeused
medically, but in this case it is not clear which part was used. If we accept
sleeptoindicate sexual intercourse, we can assume thatthe seeds or roots
were used to strengthen sexual prowess. The seeds also are known for their
power to cure dreaming of ejaculation (mengzhong xiejing ) and
dreamingofsexwithdemons (guijiao ).

it together. 6 Similarly the Yangsheng fang has many recipes involving
medicinalalcoholfortreatingerectiledysfunction.
The Suwendedicateschapter 14 to the production of medicinal al
coholicpotionsandvariousmethodsoftheirapplication.Thus,theYel
lowEmperorasksQiBohowmedicinalconcoctions,turbidalcohol,and
sweetalcoholaremadefromthefivegrains.QiBorepliesthatricemust
beusedastherawmaterialwithpaddystalksasthefaggot,becauserice
isa complete grainandricestalksarehard.
On another level, Suwen physicians also recognize how excessive
intakeofalcoholcancausehealththeproblems: Whenthepulseissmall
[andyet]bloodisplentiful,this[itisduetoexcessive]drinking[ofalco
hol]andheatinthemiddle[burner](53.1.3).
TheCijinlun (DiscourseonForbiddenNeedling)(ch.52)ad
vises physicians not only which acumoxa points not to use but also in
which situation not to treat with acupuncture. It warns: Do not insert
needles[whenaperson]isinaseriousstateofdrunkenness;itwilllead
toapersonsqibeingconfused(52.3).However,oneofmostdangerous
situationsregardingtheuseofalcoholintheSuwenishavingsexualin
tercoursewhileintoxicated.
Sex and Alcohol

Sexandalcohol,eitherseparatelyortogether,areamongtheoldestsocial
and health problems in cultures around the world and they have not
gone away (see Schuster 1988). Chunyu Yis medical records mention
two cases of diseases specifically caused by sex and alcohol (#1, 7) and
threecaseswherealcoholistheculpritwithahighprobabilityofsexin
volved. The Suwen, too, makes it clear on how the combination of sex
andalcoholisruinoustohealth.Havingsexualintercoursewhileintoxi
cated (zuiyirufang ) appears tobe acommoncausesofdisease,
so that people who treat alcohol like broth will let their lust exhaust
their essence and lose vigorat an early age(1.1).By age fifty they have
losthalfoftheirvitalenergy.Italsonotesthatsexwhileintoxicatedwill
exhaustqi andharm the liver,sothat in womenthemensesbecome ir
6 SeeHarper 1998,383n1 for discussion on what jiuzongcould be.Hesug
geststhatinthiscontext,itisaplant.
162 / Chapter Ten

regularorstayout(40.1.2).Thisshowsthattheproblemisnotconfined
tomen.
Having sexual intercourse while intoxicatedcan furthercausedry
nessofbloodaswellaslungblockageswithcoldandhotspells(10.4.2).
Thissyndromemanifeststhroughphysicalappearanceandthequalityof
thepulse.Thepatientscomplexionis paleand the pulserapidandfloat
ing. The remaining etiology corresponds to excessive sexual activity.
Duetoheavydrinking,qiwillreverseitscourse.Duetostrenuoussex
ual activity, kidney qi will be injured (3.3.2). Wang Bing explains that
whenonedrinksexcessively,thelungqiinthelobeswillrushupward
inreversalofitscourse(benqi ),whileusingforceduringsex(qiangli
)meanstooverexertoneselfduringsexualintercourse.Hefurther
adds that the flavor of alcohol is bitter and dry and thus benefits the
heart internally. On the otherhand, if one isintoxicatedand hassexual
intercourse, the heart qi willrise andmove intothe lungsystem, which
leadsto lungobstructionsyndrome.
Also,ifthereversalofqiflowcausedbyexcessivealcoholintakeis
not stopped, and if this qieventually finds it way to reside in the male
sexualorgan,itwillcausedreamsofsexualintercourse.TheLingshu says:
Whentherecedingqi...residesintheyininstrument[sexualorgans],
onewilldreamofintimate contact(43.3).
Anotherpassage notesthatitcanbequiteharmfultoexposeoneself
toacoldwindafterdrinkingoraftersweatingduetosex(42.1.2).Wang
Bingcommentsthatifheatisstrong,thepores[willopen];ifstruckby
wind, one will sweat profusely as if fluid is leaking; hence, it is called
leaking wind. The scholars of the Shandong and Hebei medical
schools state that leaking wind is another name for a disease called
alcoholicwind[syndrome].
The Suwen also mentions that leaking wind (loufeng ) comes
with profuse sweating and the inability to exert oneself (42.2). Since,
tears, saliva,and sweat, like essence,arebody fluidsthatshouldnotbe
wasted (Pfister 2003, 12). Heavy perspiration during intercourse may
createweaknessduetopathogenicwindinvasion.ChunyuYismedical
documentation in the Shiji confirms such a problem (#9). As Elisabeth
Hsu says,Sweatingseemstodesignateanaspectofbehaviouror,rather,
misbehaviour. Paradigmatic reading of the case histories revealed that
sweatingisoftenassociatedwithsexualintercourse (2001b,71).

Another examplementions that ahabitual drunkand glutton who
insistonhavingsexcancausehimselfsomedamage.Whenqireverses,it
canmanifestitselfeitherasacoldorheatrecedingcomplex.Thisisnot
a disease but a syndrome. Qi Bo explains that having sex with a full
stomach and in a state of intoxication will cause qi to enter the spleen
withnowayofdispersal.Whentheqiofalcoholandthatofgraincon
tend with each other, heat becomes abundant inside. When it fills the
body, inner heat arises and the urine will be reddish (45.1). This
matchesapassageintheYinshuwhichstatesthatinthefalloneshould
eatanddrinkasneededandenterthechamberasoftenthebodyfinds
itbeneficialandcomfortable (Wenwu1990/10:82).
Theintakeofalcoholicbeveragesbeingpartofthesocialfabricand
viewedwithtoleranceinHansocietymeantthatthecombinationofsex
andalcoholisarecurringthemeinChinesetexts.Havingsexualinter
course while in an intoxicated state is by far the most common social
misbehaviorthatcausesillnesses.TheSuwenmentionsitnolessthansix
times (1.1, 3.3.2, 10.4.2, 40.1.2, 42.1.2, 45.1). Another common motif is
food, sex,and alcohol.Alreadythe Lijiindicates:The greatdesiresof
humanbeingsaredrinks,food,andsex(ch.19).SimilarlytheShiwen#5
states thatoneshouldgivebreath as well as food and drinkto thepe
nis.TheMengzihas:Thedesireforfoodandsexare partofhumanna
ture(IVA.1).AsPaulGoldinnotes,Theimageofeatingportendssex
ual activity and that hunger is frequently seen as an image for sexual
appetiteinthe Shiji(2002,810).
The Lingshu toohas thesex,food, andalcoholmotif: Every [disease]
iscausedbywind,rain,cold,orheat,aswellasbyyinandyang[sexual
intercourse], joy and anger, food and drink, the living environment,
greatfrightand overwhelmingfear (28.1;44.1).
TheChinese relationshipbetweenfood andsexcontinuestobe an
intriguingsubject.Inthe20th century,John Weaklandstatesthatabasic
andpowerfulChineseconceptionisofsexualintercourseasanimageof
the oral relationship of feeding and eating (1956, 24447).7 These motifs
7 SeeWeakland;Muensterberger 1969. Thesestudiesarecontroversial and

theyarequotedhereonlytoillustratethefascinationwithsexualityandorality.
SeealsoMargulis and Sagan 1997, 16: Sentient life is attached tosex andfood
becausebylovinganddevouring,lifemaintainsandincreasesitself.Forsexu
alityandfoodsee Mote1977,24852;andSpence1977,27879.
164 / Chapter Ten

reflectnotonlythesocietyanditsmaladiesbut,inthecontextoftheSu
wen,depictanunderstandingofthedoctrineofmoderationinthemedi
calcontext.
The Mawangdui manuscripts mention the use of alcohol as a me
dium for making medicinal alcohol to use as remedies for various ill
nesses.However,thereisnomentionofthedangerofexcessivedrinking
ofalcoholorthatsexandalcoholaspathogenicfactorinthethreesexual
manuals.ThisagainshowsthattheMawangduistageofmedicaldevel
opmenthasnotbeensystematizedtomakethelinkbetweensexandal
cohol asapathogenicfactor. By thetime that the Suwen was compiled,
medical theories were formulated to take into account that excessive
drinking as well as having sexual intercourse while intoxicated causes
serious healthproblems.
The drinking habits of the Chinese did not change much through
history. According to Van Gulik, drinking bouts and visiting flower
houses were a favorite pastime among the welltodo class. He notes
that during the Tang and preceding dynasties, intemperance in drink
ing was a common foible, viewed with much tolerance. At banquets,
bothmen and women were wont to drink excessively (1961 178).This
behavior was so innate that sex and alcohol continued to be a major
probleminthelateMing.WangJi (14631539)wasaphysicianfrom
Anhuiprovincewhowrotecopiousnotesdocumentingmedicalcaseshe
treated.Thesewritingswerecompiledbyhisstudentsandpublishedin
theShishanyian (StoneMountainMedicalCases)in1531.The
illnessisoftenattributedtooneormorecausalfactors,usuallyrelatedto
the patients lifestyle. . . The effects of excessive sexual activity, alcohol
consumption, or overeating figure highly, particularly if the patient is
male (Grant2003,78).
Chapter Eleven
Sex and Health
What causes injury to life is sex. That is why, when the adepts
have sexual intercourse, they follow certain principles they
practice the Dao of sex.
Tianxia zhidao tan
TheancientChineseknewthatsexualexcessisunhealthy,buttheyalso
knew that no sex is harmful. Already in the 4th century BCE, the Zuo
zhuandisapproved of sexual abstinence and stated that abstinence, vol
untary or coerced, can produce both psychological and physiological
problems. In the Sun jing, the Plain Woman advises the Yellow Em
peror not to abstain from sexual intercourse because his spirit would
havenoopportunityforexpansiveness.Yinandyangwouldbeblocked
andcutofffromoneanother, andhisjadestalkwould die(Wile1992, 7
8, 85).Sex was and isnever theproblem as long as theparticipants fol
lowthebasicrulesofthe bedchamberartsanddonotengageinitexces
sively,whichastheSuwenindicates, depleteskidneyqiandessenceand
thus may lead to sickness, diminish sexual performance, interfere with
reproductivecapability, and cause prematureagingandearlydeath.
The Gu Syndrome
The oldest and most famous case of disease caused by sexual excess is
recordedintheZuozhuan(Zhao1;seeLegge1985,5:56882;Riegel2000,
110).PhysicianHeofQin diagnosedDuke Pingof Jin (r. 557532BCE)
as suffering from a disease known as gu , which is caused by ap
proaching the womans chamber (jin nshi ) excessively and
165
166 / Chapter Eleven

withoutmoderation.Heexplainsthatthe delusion causedbyexcessive
sexualactivitydestroysthemind.Sexualactivity,likeothersensoryim
pact on lifethe six climates (liuqi ), five flavors (wuwei ), five
colors(wuse)andfive sounds (wuyin)must be wellregulated.
Absorbingthis diagnosis, theduke asks whetherhehadbest avoid
allsexualintercoursewithwomen.Inresponse,thephysiciannotesthat
intercoursemustberegulatedlestitproducediseasesthatcauseinternal
heat and gu. 1 He then defines gu etymologically as consisting of the
characters for worm or insect (chong ) and bowl (ming ). He
likens it to grains that are eaten by worms or insects and then disap
pearametaphor for utter destruction. He further emphasizes that,ac
cording tothe Yijing, guas adisease iscausedby awoman deludinga
manthroughsexualindulgenceandthatitissimilartothewinddevas
tating [the trees] on the mountain. The latter appears in Hexagram 18
and is interpreted as work on what has been spoilt, i.e., decay
(Wilhelm1950,7578).
Derk Bodde translates the word gu as poison and refers to three
definitionsfromtheShuowenjiezi:1)wormsinthestomach,2)nocturnal
emissions, and3)the ghosts ofpeople whohave sufferedpublic execu
tion (1975,10001). PaulUnschuldprovidesadetailed discussionof gu,
startingwiththeShangdynastywherethecharacter firstappearsonora
clebones. Hementions fourcontexts. First, gu isdescribed as a worm
spiritindemonicmedicine:itcouldwreckthebodyofitshumanhost.
Second,guisarealpoisonthatcanbemanufacturedformaliciouspur
poses.Third,itis associated with an illnessresultingfrom [sexual] ex
cesses as described intheZuozhuan.Fourth, in amore Confucian con
text,itisadiseasecausedbythesocialatmosphereofenvyandinten
tionallypreparedtoobtainthewealthofothers.Thislastdefinitionis
close to black magic used to cause illnesses in another person for the
purpose of revenge or envy (Unschuld 1985, 4650).Wolfram Eberhard
demonstrates that gu originated in the south and gives information on
how the poisonanditsantidotearepreparedandused(1968,14952).
The Wushier bingfang mentions eight types of gudiseases con
nectedwithinsectsthat havenothingtodowithsex(Harper1998,7475).
1 The flaccidity syndrome is often associated with heat in the five organs,
whichinturncauseslaxityinthecorrespondingtissues(44.1).Erectiledysfunc
tionisalsoaflacciditysyndrome.
Sex and Health / 167

Guisalsonotunlikeyu ,a diseasefromNanyue(southChinaorViet
nam), contracted when women entice men to practice debauchery in
smallstreams.TheTreatiseontheFivePhasesintheHanshucitesLiu
Xiang(ca.776BCE)assaying:Thefemalesaredominantandproduce
disorderlyqi[inthemen]andthatiswhythesage[Confucius]namedit
yu.Thetwosyndromesaresimilarinthattheyarebothpropagatedby
womenand causedelusionanddeception.
TheSuwendescribesthesymptomsassociatedwith gu:[Whenthe
diseaseis]nottreated,thespleentransmitsittothekidneys,whichleads
toprotruding abdominal lumps [shanjia ].The lower abdomen feels
tense,hot,andpainful.Oneemitsawhite[substance].Anothernameis
gu.Atthis stage,itcan[betreated]withmassageordrugs(19.2.3).
Wang Bingnotes thatthephraseemitsa white substance(chubai
) means that urine is discharged with a white fluid. At the same
time,thefleshfeelsasifitisfoodforwormsorinsects.Itwastesaway
internallyday by day. For thisreason,it is alsocalledgu.Wu Kun in
terpretschubaiasexcessiveturbidity(yinzhuo ),whileMaShiadds
that what is emitted in white color is urine discharged with a white
fluid.
Asadisease,gu herehasmovedfromthemoralisticand metaphysi
cal to a more evidential level: its cause is not just psychological but
physical through sexual excess. Though the latter is not mentioned di
rectlyasthecauseoftheinvoluntarydischarge,thereisasimilarcondi
tionwhichspecificallyhas excessiveintercourseasacause. Thetext says:
Entering the bedchamber excessively will cause the ancestral tendon to
slackenandrelax.Thisleadsto tendonflaccidityandeventuallytoanover
flowofawhite[substance].Thus,accordingtotheXiajing,tendonflaccidity
comesfromallowing[thepenis]inside[thewoman].(44.2)
WangBingscomment to thispassage definesthe whitesubstance

more closely: It resembles the consistency of semen. In men, it flows
down like urine; in women, it flows fromthevaginalike satin.Zhang
Zhicongstatesthatitiscausedbyabundantfireoflustand[afterex
cessivesexualintercourse]spermisemittedinvoluntarily.MaShiadds
that in men, it is the involuntary discharge of semen; in women it is

[discharged]aswhitebelt.2 Thesecommentsinferthattheoutflowis
a symptom caused by excessive sex, and is associated with gu in both
menandwomen.TheLingshusaysthatwhilemenhavegu,womenact
likeDan[Ji]: theirbodies andspines feelasifthey weresplitting.
Dan Jiwas a womanof illreputedescribed inthe Lienzhuansec
tionon Perniciousand DepravedWomen(ch. 7).She wasthe wife of
King Zhou(d.ca. 1122BCE),the lastruler ofthe Shang, famous forhis
dissolutelifestyle,loveof alcohol, and engagementinlewdpleasures.He
issaidtohavestoredupgrainuntilitwaslikeahill,letwineflowuntil
it filled apond, andhung upmeat likethe forest.He was sobesotted
withDanJithathemademenandwomenpursueeachothernakedfor
longnightsoffeastinginordertopleaseher.Heeventoreouttheheart
of one of his ministers who chastised him for following a womans
counsel, sothatDanJicouldseeiftheheartofasagehad sevenorifices.
TherecordsdepictDanJinotonlyastheevilwomanwhocausedguin
King Zhou, but also as suffering from nymphomaniac desires, another
form of gu. Because of her, the king was so deluded that he lost his
sensesandwasunabletopracticevirtue.Afterhewasdefeatedinbat
tle, he killed himself which ended the Shang dynasty. Dan Ji was be
headed(OHara1978,18789).
TheLingshuphrase, menhavegu, women actlike Dan [Ji]infers
that when a man is deluded by sex, he suffers from gu, i.e., he com
pletelyloses his senses and acts as ifhehadbeendevastatedby wind
[gone mad], while when a woman is deluded by sex, she behaves like
DanJi. The Taisu confirmsthis:
Whenamanisdeludedbyawoman[tosexualexcesses],hesuffersfromgu
andhis bodybecomeswildandwasted.Heloseshisreasoning,cannotdis
tinguishrightfromwrong,andisinastatelikeintoxication.Whenawoman
isdeluded[tosexualexcesses]byaman,shesuffersfrombehaviorlikeDan
Ji.Herbodyisweakened,jaundiced,emaciated,andshetooisinastatelike
intoxication.(ch.30)
2 Baidaiisthedescriptionofthedischargei.e.whitishincolorandstrandor
beltlike. In TCM, baidai is known as leucorrhea, which must be distinguished
according tocolor,consistency andsmell.A white discharge indicates a cold
pattern. This could be caused byspleen or kidneyyang deficiency, or exterior
colddamp,orsometimesfromstagnationofliverqi (Maciocia1989,161).

The Lingshu notes more generally that too much sex is bad for
health,especiallyofthekidneys(4.1.1;66.4).Notonlyexcessivephysical
sexual activities can cause disease, but also excessive sexrelated emo
tionssuchaslust.Forexample:Cravingsandlustthatareunbridledas
wellasendlessworryandanxietydiminishandruinessentialqi(14.2).
GuoAichunstatesthatcravingsandlustmeansemotionsandlust...
and diminish and ruin indicates a state where essential qi is weak
ened. Unbridled emotions such as excessive sexual cravings and lust
are badforhealthbecause theyexhaustessenceusuallyassociatedwith
excessivedesireoractivityandthuslead todeclineand ailments.Being
obsessedwithsexislikeanyotherexcessiveemotion:itinjuresthebody.
Ontheotherhand,illnessessuchasliverwind(ganfeng )canaffecta
persons attitude toward sex: The manifestation of liverwind comes
with profuse sweating, aversion to wind, tendency toward sadness, a
slightly green complexion, a dry throat, a tendency toward anger, and
nowandthenthe detestationofwomen (42.2).
Theemotionalstateofhatingwomen(misogyny)thusisapsycho
logical symptom in the etiology of liverwind. Here the Suwen has
movedfromthephysicalintothepsychological,givingpathologicalfac
tors of the mind just as much prominence as those of the body. This
again indicates just how much medical thinking advanced from the
mundaneintotheabstract inthe courseofthe Handynasty.
WangBing,too,wasawareofsexualexcessasafactorcontributing
tothedeteriorationofhealth,thedevelopmentof ailments,andprema
ture death. He felt compelled to emphasize those passages related to
sexualexcessandthelossofessence,focusingespeciallyonthefirsttwo
chapters,whichdealmostlywithlongevity doctrines.Thisthinkingalso
continuedintotheSongdynasty,whenitplayedaroleinforensicmedi
cine. Death due to sexual excess is one of the causes of death in the
Xiyuan jilu (Collected Writings on the Washing Away of
Wrongs)bySongCi. It states:
When men die asa result ofsexual excess, it is because their vital energies
have been exhausted. When men die while having sexual relations with
women, the facts of the case must be investigated, if it is really a case of
death from this cause, the erection will not have subsided. If notthen it
wouldhavesubsided.(McKnight1981,151;seealsoEberhard1967,6165)

As early as the Zuozhuan the Chinese identified excessive sexual
appetiteasthecauseofillness.BoththeSuwenandLingshudescribethe
pathological processes clearly. Indulging in intemperate sexual activity
maybeanunderstandablehumanfoiblewithnaturalandpsychological
roots,buthavingsexexcessivelyandespeciallywhenintoxicatedseems
to have beenacommonformof misbehaviorintheHan.
Sexual Dysfunction
Sexualdysfunctionasasocialandpathologicalafflictionmustbeasold
ashumanityitself.Itaffectsmenmorethanwomenbothphysicallyand
psychologically.Womensproblemsinsexualactivityoveralltendtobe
less visible than mens, however, for women the consequences are
harsher, since the inability to conceive is a serious issue. Both the
Mawangdui manuscripts and the Suwen discuss mens sexual dysfunc
tionmoreoftenandinmoredetail,partlybecauseofthephysicalnature
of their sexual endowment, but also because men in early China were
supposedtobemoversandshakers,empoweredtodominateandleadin
publiclife,aswellas sexuallysuperiorathome.Menideally ranthestate
intimeofpeace,wenttowartoattacktheenemyorprotecttheirhome,
andinthefamilyruledovertheirwomenfolk.
Notbeingabletogetanerectionmightbeaproblem,buttheinabil
ity to produce progeny was a catastrophe. A mans social standing
would be jeopardized and his power at home seriously compromised.
Therefore, sexual prowess, authority, and power were closely intercon
nected.Any kindof sexual dysfunction wasconsidered notonly a per
sonal loss but a failure in society (Farquhar 2002, 48). What good is a
man serving as a high official in society with power over thousands of
households ifhehasnocontrolevenoverhisownmember?
Even today, sexual dysfunction in healthy persons is confined
mostlytomen.ThefourmostcommonmalesexualdisordersinWestern
medicalliteratureare:1)erectiledysfunction,2)prematureejaculation,3)
spermatorrhea, and 4) nocturnal emission. Erectile dysfunction, com

monlyknownasimpotence,3 isbyfarthemostcommonsexualdisorder
thataffectsmostmenatsometimeintheirlives.Prematureejaculationis
saidtohaveoccurredifthemanejaculatesbeforehewantsto,beforehis
partnerwantshimto,oriftheejaculationoccursbeforethepenispene
tratesthevagina.4 Spermatorrheaistheinvoluntaryemissionofseminal
liquidintheabsenceofsexualexcitementorintercourse;itcanoccurat
anytimeoftheday.Nocturnalemissiontakesplaceatnightandisusu
ally accompanied by sexually stimulating dreams. There is no direct
mention of premature ejaculation or nocturnal emission in the Suwen.
Spermatorrheaismentioned onceasadiseasecausedbyexcessivesexual
intercourse(44.2),andtherearetwodirectreferencestoerectiledysfunc
tion(yinwei ) (5.4.2; 70.3).
TheYangshengfangandZaliaofangsuggestthat sexual dysfunction
wasacommonprobleminthesexuallifeoftheQinandHanelite.Both
include numerous recipes for treating sexual dysfunction as well as for
enhancing sexual performance. The Yangsheng fang contains cures for
erectile dysfunction, increasing the size of the penis (jia ), boosting
malesexualprowessbyregulatingyang(zhi[yang][])orwashing
themaleorgan(xinan)withaconcoctiontostimulateit,facilitating
sexual intercourse (shijinnei ), and generally improving relations.
Thereareprescriptionsforwomenonhowtotightenthevaginaandin
creasepleasure(LiandMcMahon1992,15152; Harper1998,32862).
ThewordimpotencecomesfromtheLatinimpotentia,meaninglackof
power.Itwasfirstusedtodescribelossofsexualpowerin1655butapparently
isunfashionabletoday,thoughitremainsanaptdescriptionofthecondition.
4 The biomedical definition of erectile dysfunction (ED) is the inability to
achieve or maintain an erection for the satisfactory completion of sexual inter
course, i.e., an adequate erection of sufficient hardness, maintained for a suffi
cient length of time of intercourse that ends in ejaculation and provides sexual
satisfaction for both partners.In most cases, ED is caused by psychologicalfac
tors,whichmaybetemporary(e.g.,causedbyfatigueorstress)orlongstanding
(e.g.,duetofeelingsofanxietyandguilt).Inabilitytoperformsexuallymayalso
beaccompaniedbysymptomsofseveredepression.About10percentoferectile
dysfunctioniscausedbyphysicaldisorders(e.g.,diabetesmellitusoradisorders
ofendocrinesystem)orbyaneurologicaldisorder(e.g.,thedamagetothespinal
cord or alcoholrelated disorders). The problem is more common as men get
older,possiblybecauseofalteredcirculationor,occasionally,lowerlevelsoftes
tosterone.See Smith1990,574;Brewer1999,137152;McMahon1993,5085.
3

The Mawangdui manuscripts are concerned mostly with various
failuresofsexualmechanics, perceivedasthe basisforsatisfactorysex,
whereastheSuwendepictssexualmalfunction aspart ofthe etiology of
diseaseandthereforeofmedicalissues.Forexample,itdescribesthedis
easecalledkidneywind,which ismarkedbyprofusesweating,aver
sionto wind,apuffy face,spinal aches thatpreventone from standing
upright, a sootcoloured complexion, and the inability of the hidden
twists(maleorfemalegenitalia)tofunctionsmoothly (42.2).Inthispas
sage,inabilitytoperformsexuallyorsexualdysfunctionbecomespartof
the etiology ofkidneywind disease.
However, terminologies for the description of sexual dysfunction
canalsobegenderspecific.TheYangshengfangusesbuqi (notrising)
to denotethe failureto have an erection. There arethree recipes for the
conditionnotrisingduetooldageandonerecipeforsimplenotris
ing. The Tianxia uses wu (incapacity): When [the penis] has great
desirefor[sex]andisunable[toperform],itiscalledincapacity.
ThemostcommontermsintheSuwenincludeyinflaccidity(yin
wei), not rising (buqi), and unusable (buyong). As regards the first,
theHanshu(ch.53)mentionsthatPrinceTuansufferedfromyinflaccid
ityeverytimeheapproachedawoman.Wei byitself,asYangShangshan
describesitintheTaisu,isaconditionofpowerlessness,lackofcapa
bility, given to weakness,or beingrendered useless.According to
Paul Unschuld, wei may originally have only denoted the inability to
walk. However, it was subsequently subsumed under the five phases
andyinyangdoctrines,sothatitsmeaningofincapacitycametoex
tendtoawiderrange,includingageneralstateofexhaustionleadingto
the loss of ability affecting all the organs and their correlatives. Hence,
Unschuld translateswei as limpness andsaysthatit isnotalabelfora
disease,norisitastandardsymptom.Limpnessmeansalackofstrength
orfirmness;itmeansdroopingorexhaustion...ormaysimplybeasign
of being tired or of getting old (2003, 21217).The syndrome is some
timesalsoknown asyangwei , general weakness of yang orpositive
lifeenergy (Luo1995),orsimplypenislimpness.
The Suwen devotes a wholechapter tothe wei syndrome. Itshows
thatflaccidityisasyndromethataffectsnotonlythepenisbutallother
parts ofthebody.Itsays:

Heatinthelung.... leadstoflaccidityofthelegs.
Heatintheheart .... leadstoflaccidityofthevessels.
Heatintheliver .... leadstoflaccidityofthetendons.
Heatinthespleen .... leadstoflaccidityoftheflesh.
Heatinthekidney ....leadstoflaccidityofthebones.
If vessels, tendons, flesh, and bones are flaccid, limp, tired, ex

hausted,ordrooping,itfollowsthatthemostaffectedphysicalfunction
ofthebodywillbemobility,andwalkingisthemostbasicofallmove
ments.Ontheotherhand,sincethegreaterpartofthepenisismadeup
ofskin,tissues,bloodvessels,andnerves,itisnotsurprisingthatwhen
flaccidityoccurs there,itsetsthestageforerectiledysfunction.
TheSuwen statesthat if aman understands theseven ways ofdi
minishing and eight procedures of increasing [qi], he can regulate his
sexual behavior and therefore prevent injuries that lead to premature
aging and early death. Those who know the bedchamber arts will live
outtheirallottedlifespanbutforthoseignorantoftheDaoofsex,there
will be early weakening of joints and other parts of the body (5.4.2). It
further links sexualflacciditytothe winterseason, when the weather is
dampandovercastandthereislotsofdust.Atthispointqicannotflow
smoothly in the chest and there may be sexual dysfunction (70.3). The
Lingshumakes thesameconnection:[When the kidney pulse] isbig, it
indicates yinflaccidity (4.2.4),but it also allows for thepossibility that
thisoccursduetoheatratherthancoldordampness(13.1.12)orbecause
amanhasaninjury to hissexualorgan(65.2.1).
Another dimension of sexual dysfunction is the injury inflicted to
thesexualorganofmentoturnthemintoeunuchs.Eunuchshavealong
history in China. Oraclebonesfromthe reignof King Wuding (r. 1720
1691 BCE) showthem aspartoftheShangcourt.However,the earliest
writtenreferenceappearsinthe Zuozhuan oftheyear535.TheZhouli
(RitesofZhou)callsthemsiren :menwhotakecareoftheemperors
women andareincharge ofpunishment. Theirpresence wassopromi
nent during the Eastern Zhou that it offended Confucius, who left the
stateofWeiafteronlyamonthsstay.TheShijingsays:
Notheavenbutwomenandeunuchsbringmisfortunetomankind.
Wivesandthosewithoutballsbleatwithsimilarvoices.

BytheEasternHan,underEmperorHuandi(r.14667CE),eunuchs
wereacknowledgedasanevilinfluencethatcouldbringruintoanem
pire (Tsai 1996, 1112). Their influence continued throughout Chinese
history and in factruined the empire onmany occasions. However, the
mostfamousofalleunuchsintheHanisthecourthistorianSimaQian,
who wascastrated forpoliticalreasons underEmperorWu(r. 140187).
HelivedforanothertenyearstofinishthehistoricalrecordShiji(Goldin
2002,7577).
Henry Tsai also provides a description of the physical and physio
logical changes that took place after Wei, the infamous eunuch in the
Ming,wascastratedattheageoftwentythree:
Thereisanapparentlossofheightandbeard;hisnosehasbecomebroader
andhisearlobesthicker.Decreasinghormonelevelcausedlossofelasticity:
his skin wrinkled, his joints stiffened and his muscle strength gradually
weakened. His nail had a dull yellow appearance, the halfmoon disap
pearedandthenailsdevelopedridges.(1996,45)
ThoughWeilivedinMingChina,thisdescriptioncertainlyapplies
to eunuchs in ancient timesafter all, the physical and physiological
characteristics ofhumanbeingshavenotchangedmuch inthe last five
thousand years. Therefore, any damage to the male sexual organ pro
duceschangesinthe physicalappearanceofthe man.
Another explanation for erectile dysfunction is vessel theory.
Amongthevessels,theJueyin[liver]Vesselofthefootjoinsatthegeni
talsandlinksupwiththevarioustendons.Shouldtherebeatendondis
order,theinnerthighwillhurtandspasm,andsexualdysfunctionmay
result.Differentspecificcausesinternalorexternal,coldorheatlead
to various forms of flaccidity, but the connection to the vessels is made
clear.Yetanothercauseisnatural aging,which meansthattheamountof
essenceisreducedovertimeandadiminishingofsexualprowessoccurs
startingaroundatageforty,culminatingintheinabilitytohavechildren
around the ageofsixtyfour.
Given the importance of eugenics, it is obvious why the subject of
sexual dysfunction preoccupied the early Chinese. Sexual dysfunction
wasnotjustamedicalproblem,buthadwidespreadsocialimplications.
AsVivienneLoemphasizes:Promotionofreproductivehealthandpre
ventionofsexualweakeningwerealwaysacentralfocusofChineseself
cultivation (2005, 246). As such, considerable efforts were channeled

intomakingsurethatsexualandreproductivephysiologyfunctionsop
timally includingtheuseofaphrodisiacs.
Aphrodisiacs and Philters

Uses of aphrodisiac recipes to arouse desire, increased strength, and
stimulate the genitals are evidently quite acceptable in sexual cultiva
tion(Harper1998,140).Forexample,theYangsheng fangandZaliaofang
devote considerable space to aphrodisiac and philter recipes for both
men and women. They include prescriptions for erectile dysfunction
both in youngerman anddue to old age. There are alsophilterrecipes
forincreasing[penis]size,tighteningthevagina,andgenerallyin
creasingpleasure.Harper arguesthatsuch recipesare primafacie evi
dence that the idea of sexual cultivation did not define sexual experi
ence... nordiditdiminisheroticism (2005,93).
TheSuwendoesnotdealwithaphrodisiacsorphilters.However,it
containsaprescriptionthatalludestorestoringmalepotencyinarecipe
for dryness of blood caused by having lost a large amount of blood
when young and engaging in sexual activity while in an intoxicated
state. Itsays:
Use four [portions] of black cuttlefish bones and one [portion] of madder
root.Combinethemwithsparroweggstoformpillsthesizeofsmallbeans.
Take five pills before meals by drinking abalone brothwiththem. This will
smooth the intestine and the middle, and aid the injured liver. (40.1.2; see
also Taisu 30)
TheBencao gangmu(CompendiumofMateriaMedica)states
thatblackcuttlefishbones (Os Sepiellaeseu sepiae),madder root (Radix
Rubiacordifolia),andabalone(Haliotis)areeffectiveforremovingblood
blockages,whilesparroweggs(Passermontanussaturatusstejneger)are
usedtorestoremalesexualfunction.Sparroweggsarelistedas:sourin
flavor,warminnature, and nonpoisonous.Theyarebest collectedinthe
fifthmonthandshouldbetakenfordescendingqi,sexualflaccidity,and
erectile dysfunction. It will strengthen these with heat and increase es
sence, sothatonecanhave chldren.
TheShiwen(#2)encouragesmentoeat springdickybirds (including
sparrow)eggstoreplenishessenceiftheyintendtoconductsexualinter

course frequently. The Yangsheng fang and the Wushier bingfang also
haverecipesusingtheseeggstoimprovesexualfunction.Absenceofthe
mentionofaphrodisiacand philter recipesinthe Suwenindicatesthatthe
Mawangduimedicalcorpus isstill in the period ofpracticing recipes
whiletheSuwenphysiciansseessexualdysfunctionaspartofthemedi
cal equation and are treated according to medical theories. There is no
mentionof philters ofanykind.
Sexualdysfunctionisseenasadiseasewithgraveconsequencesfor
bothmenandwomen.TheSuwendescribesmanycausesandsymptoms
of sexual problems and disease, but it does not offer many practical
methods like the Yangsheng fang. Failure to get an erection is gender
specific,butwomentoosufferfromvariousformsofsexualdysfunction,
which may also lead to premature aging and various diseases. The Su
wensmostimportantmessageonsexandhealth,therefore,istorelyon
medicine for acute conditions and study the bedchamber arts for long
termhealthwhileatalltimes avoiding thedangerouscombinationofsex
andalcoholandrefraining fromexcessivesexual activity.
Chapter Twelve
Sex in the Suwen
The love of food and everything sensual is human nature.
Mengzi
BystudyingsexandsexualityintheHuangdi neijing suwen,Ihaveshown
that longevity techniques, and especially the bedchamber arts, influ
enced the development of medical theories. I did so by looking at how
longevity doctrines in the Yangsheng Chapters acted as a bridge for
the transition from pure longevity materials to systematized medical
theories. The Suwen medical theories represent a stage in the develop
ment of Chinese medicine when theories are welldefined and sex and
sexuality playaclear partinpathology,etiology,anddiagnostics.
TheMawangduicorpusandthevariouscategoriesofpreHanand
Han literature reveal sexual culture in different historical, intellectual,
andsocialcontexts.ThethreeMawangduimanualsindicatethatsexand
sexualitywasanintegralpartofhealthandlongevity.Theirdescriptions
ofthe bedchamberartstogetherwiththelatestarchaeologicalfindingsof
erotic objectsfromtheHan impart important information on early Chi
nesesexualculture.All dating from the Handynasty, they providethe
synchronic dimension of this study. Materials pertaining to sex and
sexualityinothermoretechnicalmedicaltexts,suchas the Nanjing, Taisu,
and Lingshuas well as the numerous later commentaries of the Su
wenprovide the sources for diachronic comparison. The texts reveal
that sexual intercourse is problematic if performed without knowledge
ofthe Daoofsex, discussed especiallyalso withinmedicaltheories.
The Mawangdui manuscripts show that in the early Han medical
theorieswerestillatthestageofformingpathologicaland physiological
theories and medical practices still meant the practice of recipes.
177
178 / Chapter Twelve

Acupunctureplayednorole,andonlyelevenvesselswereknown.The
vesselsweredividedintoyinandyang,butfewtheoriesrelatedtothe
flowofqi.TheSuwen,ontheotherhand,advocateswelldefinedphysio
logicalpathways ofqi,etiology throughthe description ofpathological
mechanisms,diagnosisby pulse examination and othermethodsof in
vestigation, as well as treatment by acupuncture. This shows that it
representsamoreadvancedstageinthedevelopmentofmedicaltheo
ries.
This shift arose, no doubt, out of the multifaceted development of
Han society. TheMawangduimanualshighlight the importance of sex
ual cultivation as an important branch of longevity techniques. They
employ sex to enhance health, prevent sickness, and achieve longevity.
Suwen physicians, on the other hand, explain health care and disease
based on natural phenomena (climatic conditions), psychological mani
festations (extreme emotional changes), lifestyle choices (human behav
ior, including sexual intercourse), and living conditions (environment).
They advocate acupuncture based on medical theories as the technique
ofchoicefordealingwithdisease.
TheSuwen describeshealthproblemscausedby sexual intercourse
by referring to wellformulated diagnostic, prognostic, and treatment
methods. It thereby does away with traditional concepts of health care
based on good and bad luck and the belief that human ailments were
caused by demons, sprites, spirits, ancestors, and other supernatural
agents. The Suwen promotes principles that encourage people to take
responsibility for their own health by looking at their behavior in rela
tiontonatureandto seek medicalexplanationsandsolutions.
UnliketheMawangduimanuals,theSuwendoesnot presentsexual
techniques. Yet it mentions the seven ways of diminishing and eight
proceduresof increasing [qi]withoutgoing into anydetail,confirming
theassumptionthatanyonereadingtheSuwenwithregardtohealthand
sicknesswouldknowthesetechniquesandthushavesomebackground
knowledgeof thebedchamber arts. Sex isset inthe humanrealm of fa
miliar daytoday living, i.e., it occupies a role in health, sickness, and
death.
The Suwenphysicianslink thesexualactwithpathological,diagnos
tic, and therapeutic roles in health and reproductive physiology. They
portray sex in a wide context within the medical environment of their
time by integrating it into various medical theories as presented in the
Sex in the Suwen / 179

differentchapters.Thesexualacthereisbothacauseaswellasasymp
tomofdisease.
Findingabalanceineverythingistheoverridingtenetthatperme
atestheSuwen.Regulationandmoderation,e.g.,nottoomuchandnot
toolittle,isthekey.Anyexcessordeficiencywillmanifestitselfasdis
easeandsexualexcessesisamajorcause.Sexualdiseasesandcures,too,
arebased on anobjectified view ofthe world withno trace ofpersonal
search for higherlevel truth or immortality; there are no moral or reli
giousconnotations.Medicinehas becomeempiricalandisnowbasedon
objectiveobservationandthetheoryof causeandeffect
ThenewmedicalthinkingofthetimeenabledtheSuwenphysicians
tomedicalize andphysiologize sex.Theypresentreproductivephysiol
ogy withoutmoralistic,religious,spiritistic, ormagicalovertones,and do
not ascribe the creation of offspring to creation myth or supernatural
forces.Instead,theydescribetheseprocessesin greatdetailasempirical
concepts, seeing human beings as the product of the sexual union be
tweenmanandwoman.
The body is anatomized in the Suwen. Sexual anatomy is catego
rized and described in a plainly straightforward manner and they play
importantrolesintheformationofthemedicalsystem.Maleandfemale
sexual anatomies are clearly distinguished and these sexual entities are
incorporated as part of the medical equations, as symptom, disease or
therapy,andconsequentlybecomecomponentsofmedicaltheories.
This produces a medicalized atmosphere in which physiological
processes,reproductivehealth,fertilityandtheagingprocessinmenand
women are discussed rationally in relation tomedical theories.There is
nosearchforimmortalityliketheimmortalitycult.Themainobjectiveis
to live outthe lifespan allottedby heavenor nature andnot todiepre
maturely.This indicates a soberand objectiveperception of the organic
nature of life itself. Thecompilation of theSuwen signifiesanew direc
tion in which innovative ideas ondealing withhealth anddisease were
notonlypresentedasanalternativetothetraditionalthinkingbutwere
backedbywelldefinedtheories.
The Mawangdui manuscripts, in terms of sexual vocabulary, are
still in the longevityphasebeforesystematizedmedicine, while the Su
wenhas movedtowardanew,clinical,andcodifiedvocabularythattries
todefinesexualintercourseinamedicalframe.Manysexualexpressions
foundinthemanuscriptsdidnotsurviveintotheSuwen.Sexualphrases,
180 / Chapter Twelve

suchasenteringthe bedchamber,lettingin,andusing[the penis],
on the other hand,became standard expressions for sexual intercourse.
In addition, the Suwen itself has several terms and abstract concepts
notablytheheavenlystockandtheancestraltendonwhichdidnot
surviveandareonlyfoundthere.
AlthoughtheexaminationofsexinearlyChinadidnotleadtothe
developmentofthefieldknownassexologytoday,itstillplaysanim
portant role by setting the stage for the development of other medical
fieldsofstudy,suchasgynecologyorobstetrics,inwhichwomensdis
orders relating to reproduction were treated as a separate field that re
quiredspecialtraining.
The identification, documentation,and analysis of sex revealsome
interesting motifs. The most common is sex and the use of alcoholic
drinks, i.e.,having sex while in an intoxicated state. Other motifs used
aredrink,food,andsex orjustfoodandsex. Thesemotifsreflectnot
onlyancientsocietyanditsmaladiesbutinthecontextoftheSuwende
pictanunderstandingofthedoctrineofmoderationinthemedicalcon
text. TheSuwenthusrepresentsadevelopmentfromamagicospiritistic
environmentintoonethatismoretheoreticalandempirical.Itembraces
theexpressionof asystematic,welldeveloped Chinesemedicalthinking,
which integrates theoretical knowledge with clinical observation and
practice. Diseases can now be diagnosed and treated with appropriate
techniques, and thehealingprocess is observedandrecorded.
TheSuwenYangshengChaptersclearlyencapsulatetheshiftfrom
longevitydoctrinesandbuddingmedicaltheoriesintowelldefinedand
systematizedtheories.BythetimeHanscholarphysiciansfinishedcom
piling theSuwen,medical theorieshadbecomedefinedandwell organ
ized. Themedicaltheories ofthetextinduecourse becamethemodelfor
allothermedicalbooks.TheSuwenspresentationofsexwithinthecon
finesofthese medicaltheories,therefore,providedthebasisforallfuture
understandingofhumansexandsexualityinChineseculture.
Translations
Suwen 1.3
(FromOnHeavenly Integrity inHighAntiquity)
: , , . : , ,
. , , , , .
, . , , . ,
, . , , . , ,
, , .
, . . , , , ,
. , , . ,
. , . , , .
, . , , , , , ,
,. , , ,
. , , .
TheEmperorsaid, Whenpeopleageinyears,theycannothavechildren.
Isitduetotheexhaustionoftheirmaterialstrength[reproductivepoten
tial]orisitaccordingtotheheavenlynumbers [age]?
Qi Bo said, For female, at seven years of age, her kidneyqi is
abundant;shechangestoherpermanentteeth;andherhairgrowslong.
At 2 times 7 [14] years, her heavenly stock [tiangui] arrives, her
Conception Vessel becomes penetrable, and her Penetrating Vessel is
abundant. Her menstruation begins and sheisableto bear children.
At3times7[21]years,herkidneyqiisbalancedandeven.Herwis
domteethappearandshegrowstoherlimit.1
1 Herphysicalgrowthiscomplete.Similarly,inbiomedicine,attheageof
seventeeneighteen physical growth is complete. Her body becomes fuller and
rounder, the growth of her skeleton ceases, her genitals are mature, her men
struationstaysregular,andherbonesgrowharderandchangeinproportion.
181
182 / Appendix
At4 times7 [28]years,hertendonsandbonesbecomefirm, herhair
growstothefullest, andherbodyisfullandstrong.2
At5times7[35]years,herYangmingVesselsweaken;3 herfacebe
ginstobecomeparched[wrinkle];andherhairbeginstofall out.4
At 6 times 7 [42] years, her three yang vessels5 weaken from the
above;herfaceisentirelywrinkled;andherhairbeginstogrey.
At 7times 7[49]years,6 herConception Vessel isdepleted andher
Penetrating Vessel weakens and lessens; her heavenly stock is ex
hausted and the earth channel [of her uterus] becomes impassable
[leadingtotheabsenceofmenstruation].Hence,herbodyisflawedand
shecannothavechildren.7
2 Shecontinuestodevelopsexually,andhermenstruationisregular.Ifshe
stayshealthy,sheremainsfertileuntilaroundagethirtyfive.Afterthirtyfive,a
womanschancesofconceivingnaturallydeclinebyasmuchasfiftypercent.
3 Wang Bing comments: The Yangming vessels [foot and hand] rule the
face.Hence,whentheyweaken,thehairwillfalloutandthefaceisparched.He
cites the Lingshu which describes the pathways of the foot Yangming (stomach
Vessel)(10.2.3)andhandYangming(LargeIntestineVessel)(10.2.2).
4. In most women today, it is also around thistimethatthe first wrinkles
appearandtheirhairbecomeslesslustrous.Thisprocessisnotdifferentfromthe
paththatwomeninearlyChinahavetaken.
5 The three yang vessels mentioned here refertothe Taiyang (Major Yang
or Small Intestine), Shaoyang (Minor Yang or San Jiao), and Yangming (Yang
BrillianceorLargeIntestine).Thesethreevesselsascendlaterallytothefaceand
whenqiandbloodaredeficientinthesevessels,itwillcausetheirappearanceto
ageandhairtoturngrey.
6 Inindustrialcountries,menopause(thedateofawomanslastmenstrual
period)usuallyoccursbetweentheagesoffortyeighttofiftyfivewiththeme
dianatfifty.Awomanissaidtobeinhermenopauseifmenstruationhasceased
for more than six to twelve months. Climacterium or perimenopause is the
phaseinawomenslife,duringwhichshemakesthetransitionfromareproduc
tivetoanonreproductivestage.Thistransitionisaperiodofdecliningovarian
function which usually spans two to five years and it is also accompanied by
physicalandpsychologicalchanges,whichoccurredasaresultofreducedpro
ductionofestrogenbytheovaries.Thefolliclesintheovariesstopproducingova
(eggs) and less estrogen is produced. This leads, eventually, to the absence of
menstruation.
7 Wang Bing comments that [the flow of] menstrual water is severed and
stopped,causingtheearthchanneltobecomeimpenetrable.WhenthePenetrat
ing and Conception Vessels weaken and diminish, it is said that her body is
Translations / 183
For a male, at eight years of age, his kidneyqi is replete; his hair
growslong;andhechangestohispermanentteeth.8
At 2 times 8 [16] years, his kidneyqi is abundant; his heavenly
stock arrives; 9 his essentialqi overflows and he discharges [his se
men];10 [when]yinandyangharmonize[havesexualintercourse];hence
hecanhavechildren.
At3times8[24]years,hiskidneyqiisbalancedandeven;histen
donsandbonesarestrongandfirm;hence,hiswisdomteethappearand
hegrowtoitslimit.
At 4times 8[32] years,his tendons andbonesarefully developed
andhismusclesandflesharefullandfirm.11
At5times8[40]years,hiskidneyqiweakens;hishairfallsoutand
histeethdryout.12
At6times8[48]years,hisyangqiweakensandisexhaustedinthe
above[head];hisfacewithers[wrinkles];andthehaironhisheadand
templeturns grey.
flawed andshe can no longer havechildren. This can alsobe transposedto de
scribethereproductivelifeofawomantoday.
8 Uptothisage(femalessevenandmaleseight),thereisnodifferenceinthe
developmentbetweenaboyandagirl.
9 Asageneralrule,boysmaturelaterandmoreslowlythangirlsbothsexu
allyandphysically.
10 In this context, one can assume the production of semen is subsumed
under essentialqi and when it overflows, it will have to be discharged. Wang
Bing comments that man and woman have properties of both yin and yang.
Sincetheir heavenlystock are different,then the constituents oftheir essence
andbloodarealsodifferent.Whenyiniscalm,theseawillbefulland blood
will leave.When yang moves correspondingly united, it will emit jing(semen).
Whenboth(yinandyang)communicateandcombine[togethertheirjing],they
can have children. The Great Appendix of the Yijing says: when a man and
women unite their essence,the myriadthingstransform and are brought forth.
SeeHarper 1998,391 and n3(inthe Shiwen), who translates xie asemission
(ejaculation) and in He yinyang as spilling (ejaculation) (ibid. 417). To para
phrase jingqiyixie : When essentialqi overflows, he discharges his se
men.
11 Like the woman, a man reaches his physical and sexual prowess in his
twentiesandearlythirties.
12 This is the proverbial middleage, in which a man starts to experience
sexualandphysicaldecline.
184 / Appendix
At 7 times 8 [56] years, his liverqi weakens; his tendons cannot
move.13 Thekidneyruleswater;itreceivestheessenceofthefiveorgans
andsixvisceraforstorage.Hence,whenthefiveorgansarefilledabun
dantly[withessence]thenitcanbeemitted[fordistribution].
Now, if the five organs are all weakened, the tendons and bones
become sluggish and his heavenly stock will reach its limit [ex
hausted].Hence,thehair[onhishead]andathistempleturnsgrey;his
bodygrowsheavy;hiswalkingpostureisnolongererect;andheisun
abletohavechildren.
At 8 times 8 [64] years, his heavenly stock is exhausted; his jing
[essence and semen] diminishes; 14 storage [capability] of the kidney
weakens;thewholebodyreachesitslimits[inphysicalstrength];thenhe
loseshisteethandhair.
13 Ma KW statesthatjudgingbytheliterarystyleandthecontextofthepas
sage,thereisanobviousdisarrangementoftheoriginalbambooslipsandthere
fore, part of the text of (7X8) years has been moved to the (8X8) years passage
(1989,11).
14 Itcanalsobeinterpretedthattheamountofsemenproducedislessened.
Translations / 185
Lingshu 54
(FromHeavenlygivenYears )15
: , , , ,
. : , , , . :
? : , , , , , .
: , , , , . :
, , , , , , ,
, (), , , .
: , . : , ,
, , , . : , ,
. : , , , , .
, , , . , , , ,
. , , , , , ,
, , . , , , ,
. , , , , . , , .
, , , . , , . ,
, , , . : , .
: , , , , , ,
, , , , , , .
TheYellowEmperoraskedQiBo:Iwouldliketohearaboutthebegin
ning of life of aperson.What [kindof] qi16 is used tobuild the founda
Thetitleofthechapter,HeavenlyYearsreferstothelifespanallocated
toapersonbynatureorheaven.Oneofthemainobjectivesofthelongevitydoc
trinesistoliveoutonesnaturallifespanandavoidanearlydeath.Accordingto
theadepts,thiscanbeachievedbylivingasensiblelifestylebasedonmoderation
andusingvarioustechniquessuchasphysical(daoyin)andbreathingexer
cises,dieteticsandsexualcultivation.Seealsothereferencetoheavenlyyearsin
conjunctionwithlongevitydoctrinesin Suwen 1.1.
16 Qiherereferstothebasicsubstancethatmakesupthemyriadthingsand
inthiscaseitisthedifferenttypesofqiprimordial(yuan ),constructive(ying
),andprotective(wei )andsoonthatmakeupapersonsconstitution.
15
186 / Appendix
tion?Whatmustbeerectedtomaketherailings?17 Whatwaslost,sothat
onedies?Whatwasgained,sothatonelives?
QiBoreplied: Usethemotherforthefoundationandusethefather
fortherailings.18 Thosewhohavelosttheirspiritwilldieandthosewho
haveobtainedtheirspiritwilllive.
TheYellowEmperor asked: Whatisthisthatmakesthespirit?
Qi Bo replied: When the blood and qi are already harmonized,
when rong[nutritive])andwei[defensive]qiarealreadyflowing[unim
peded],19 whenthefive organsarealreadyformed, whenthespiritandqi
arehousedinthemiddle,andwhentheetherealsoulandearthlysoul20
haveaccomplishedentirely, thepersonisformed.
The Yellow Emperor asked: Each persons [ability] to live long or die
young is not the same; some shorten their allotted life span; some die
abruptly; some are sick for a longtime; I would liketo heartheprinci
ples[reasons behindit].
Qi Boreplied: When thefiveorgans are firm and solid; when the
bloodvesselsareinharmonyandregulated;whenthemusclesandflesh
The Shuowenjiezi defines shun as lanshun railings or balustrade.
Thetwoquestions:heqizhuweijiandhelierweishunrefer
to the material required for the development of a person, internally and exter
nally.
18 MaShicomments:Thebeginningoflifedependsonthemothertobuild
thefoundationandthisisthefemaleprincipalthatformstheperson.Itdepends
onthefathertobuildtherailingsandthisisthemaleqithatisusedfordefense
and protection. Italso impliesthatthe construction of aperson issimilarto
building a house, where the foundation represents the interior and the railings
theexterior,whichisalsoassociatedwithprotectionanddefense.
19 Weireferstotheprotectiveordefensiveqianditismostlypairedtoying
but also sometimes to rong, and rongwei is used interchangeably with yingwei.
Rongmeansflourishing,plentiful,luxuriant,andlushandintheqicontext,itis
often translatedto nourishing qi.Yingqiis usually translated as campqi(Un
schuld2003,1637)orconstructive qi (Porkert1974,18890)
20 Lingshu8.1.2states:Thatwhichfollowsthespiritscomingandgoingis
calledetherealsoul(hun)andthatwhichcorrespondsto jingsgoinginandoutis
called earthlysoul (po). Needham defines hun and po in this way: The hun
souls, upwardfloating, were no doubt its yang part, and the posouls, down
wardseeping,itsyinones(1983,27).
17
Translations / 187
are smooth and flexible; 21 when the skin [structure] is tightly close;22
whenthemovementof ying (camp) and wei(defensive) [qi]donot lose
theirnormal[function];whentheinhalationandexhalation[respiration]
are light and slow; then qi moves in proper measures.23 The six resi
dences transform grains [into grainqi]; the body fluid is dispersed and
propagated; and each and everyone is [functioning] according to its
normalstandard;hence,onecanliveforalongtime.
TheYellowEmperorasked:Apersonwholivesuptoahundredyears
andthendies,howdoesoneachieveit?
Qi Bo replied: When the [qi] sending way [nasalpassage] isdeep
andlong;24 whenthefoundationandwall[ofthenoseare]arehighand
square;25 when the ying (camp) and wei (defensive) [qi] penetrate and
regulate[all];whenthethreeparts26 andthethreeli27 (i.e.upper,middle
21 GuoAichuncommentsthatjieli isalsothesameasyueli and
iscloseinmeaningto he.Theextendedmeaningofissmoothandflexible.
Yang Shangshan says, It means muscles are found in the exterior and flesh in
theinterior;eachhasseparateadvantage.
22 Yang Shangshan comments: pifu zhimi means that the skin is
closedanddense.Paraphrased,theporesshouldbefineandskintextureclosely
woven i.e. without blemishes. Cf. picou manmi from Tainxia (Ma JX,
1992,1030).AccordingtotheShuowenjiezi,Maconcludedthatcoumeanswenli
pattern(texture).Healsoquotestwodefinitionsforthegraph byWang
Bing.In50.1WangBingcommentsthatcouli referstothetextureoftheskin
andin39.4,heexplainsthat iswherethebodyfluidsemiti.e.theporesofthe
skin. It is generally accepted that cou is the tissue between the epidermis and
muscles,whichformstheskinstructurethatismadeupofdifferentlayers.
23 YangShangshancommentsthatwhenbreathinginandoutiscalm,rest
ful qi willflowsixcun[every respiration], following the measure of100kein a
dayandanight(i.e.24hours).
24 YangShangshancommentsinscroll2thattheshidaosendingway
is the way that the nose sends air [in and out of the body]. Duiyizhang
meansthatexhalationisnotobstructed.GuoAichunstatesthat duimeansdeep.
25 Yang Shangshan said, When the brilliant hall of the nose and the wall
andfoundationsarehigh,bigand square;itisthecauseofthethirdlongevity.
26 In20.2, sanbu isreferredtoasthelower,middleandupperparts.It
canbethethreepartsofthebodyorthethreepartsoftheface(i.e.upper,middle
andlower).Itisalsousedtoindicatethethreedifferenttypesof[malevolent]qi
as in66.1.ZhangZhicong commentsthat sanbuarethethree parts of the body.
188 / Appendix
andlowerpartsoftheface)areraised,28 whenthe[facial]bonesarehigh;
the[face]isfleshyandfull; [thenone]canliveuptoa100years.
The Yellow Emperor asked: Death depends on the abundance or ex
haustionofonesqi canIgettohearaboutit?
Qi Bo replied: When a persons life reaches 10 years, the five or
gansbegintostabilize,thebloodandqiarealreadyflowingunimpeded,
andthe qi isbelow;hence,oneisfondofrunning.
At20years,thebloodandqibegintofillup,themusclesandflesh
become square and long; hence, one is fond of hasting along [running
fast].
At 30 years, the five organs are stable, the muscles and flesh are
solid and firm, the blood vessels are filled to the utmost; hence, one is
fondofwalking.
At40years,thefiveorgansandsixviscera,andthetwelveprimary
vesselsaregreatlyfilled,makingthembalancedandstable.Thoughthe
textureofthekneesmaybegintothin,thelusterinthecomplexionmay
begintowane,thehairontheheadandthetemplesmaybecomevarie
gatedandgrey,[oneis]sobalancedandfullthatonecannotbeswayed.
Hence,oneisfondofsitting.
At50years,theliver qi beginstoweaken,thelobesoftheliverbegin
toshrink,thebile beginstolessenandoneseyesbeginto beunclear.
The Zhongyidacidianalso refersto the sanbu asthe three pulselocations on the

wristclassifiedascun,guan andchi.
27 MaShicommentsthatthesanliisthesameasthesanbu.ZhangJiebinin
theLeijingsays,Therearetwosanliandtheyarecalledfootsanli.Theyareacu
moxapointsonthefootYangming(stomach)Vessel.ZhangZhicongthinksthat
the sanli is the vessel of the hand Yangming, i.e., Large Intestine Vessel. The
Zhongyidacidianreferstosanliastheacumoxapointzusanli(ST36)andshousanli
(LI10).YangShanshaninscroll2commentsthatsanbuiscalledthethreeareasof
the[Triple]Warmer;sanliiscalledthesanli[acumoxapoint]belowthekneeand
itis[partof]the stomach vessel;whentheTripleWarmerandSanli[vessels?]are
all penetrable and regulated; this is the third longevity. Shandong and Hebei
scholarsstatethatsanliindicatesthethreesectionsofthefacei.e.upper,middle
andlower.
28 Ichooseto follow preferences ofMa Shi andZhang Zhicong in reading
thephraseas.
Translations / 189
At60years,theheartqi beginstoweaken;ifoneworriesandissad
den,blood and qi will beslackenedand sluggish; hence,one is fond of
lyingdown.
At70years,thespleenqi isdepleted,theskinisdried.
At80years,thelungqi isweakened,theearthlysouldeparts;hence,
onespeakswithfullofmistakes.
At90years,thekidneyqiisdriedup;thefourorgans29 andthepri
maryvesselsareemptyanddepleted.
At100years,thefiveorgansarealldepleted,thespiritandqihave
alldeparted,theformandskeletonaloneremainandthatistheend!
The Yellow Emperor asked: For those who are not able to conclude
theirlongevity(naturallifespan)anddie;howisitso?
QiBoreplied: Whenthefiveorgansareallnotfirm;30 whenthe[qi]
sending way (nasal passage) is not long [enough]; when the outside
holes(nostrils)arespreadout;31 when[thebreathing]isgaspingandvio
lentlyfast;wheninaddition,thefoundationandwallareinferior;when
thevesselsareweakandthebloodissmall[inamount];whenthefleshis
29 Taisu2 has it as zangku:the organs are dried out;the Jiayi jinghas

zangnaiweiku:theorgansbecomeswitheredanddry;theTaipingshen
huifang doesnothavethetwographs.
30 Yang Shangshan says, when the five organs are all depleted, which is
easytobesubjectedtomalevolent[attacks]andinjury.
31 Guo Aichun comments that yiandyuhavethesamesound in an
cientChinese.Therefore,thiscanbetranslatedasalso.YangShangshanadds
that when the nasal passage is short and stub and the nostrils are large, it can
causeexcessivebreathing.
190 / Appendix
not firm32 and [one is] often struck by wind and cold;the blood and qi
willbedepleted; thevesselsarenotpenetrable; thetrueandinjurious[qi]
will mutually attack [each other] causing disorder and mutual pulling
(tension); thus,theyendtheirlivesinthemiddleoftheir natural span.
32
IntheTaisu insteadof shi stone,itiswrittenasshi replete.
Bibliography
Addiego, Frank, et al. 1981. Female Ejaculation: A Case Study. Journal of Sex
Research 17.1:1321.
Akahori,Akira. 1989.The Interpretation of Classical ChineseMedical Texts in
Contemporary Japan: Achievements, Approaches and Problems. In App
roachestoTraditionalChineseMedicalLiterature, edited by Paul U. Unschuld,
1927.Dordrecht:KluwerAcademicPublishers.
Andrews,B J.1991.WangQinrenandtheHistoryofChineseAnatomy.Journal
ofChineseMedicine 35:3036.
Armstrong,DavidE.1998.AlcoholandAlteredStatesinAncestorVenerationRituals
ofZhouDynastyChinaandIronAgePalestine.Lewiston:EdwinMellenPress.
Anderson,EugeneN.1988.The FoodofChina. NewHaven:YaleUniversityPress.
Baltzer,Jrg,andHeraldMickan.1985. Gynkologie. Stuttgart:GeorgThieme.
Ban Gu. 1985 [reprint]. Hou Hanshu (Book of the Later Han) Beijing:
Zhonghuashuju.
Berger, Patricia. 1998. Body Doubles: Sculpture for the Afterlife. Orientations
2:4653.
Birrell,Anne.1993.ChineseMythology.Baltimore:JohnsHopkinsUniversityPress.
_____.1982. NewSongsfrom aJadeTerrace. London:GeorgeAllen&Unwin.
Bischoff, Friedrich Alexander. 1985. The Songs of the Orchid Tower. Wiesbaden:
Harrassowitz.
Bodde, Derk. 1975. Festivals in Classical China. Princeton: Princeton University
Press.
Bokenkamp,StephenR.1997.EarlyDaoistScriptures.Berkeley: UniversityofCali
forniaPress.
Brewer,Sarah.1999.CompleteBookofMensHealth,London:Thorsons.
Brooks,BruceE.,andTaekoA.Brooks.1998.The OriginoftheAnalects. NewYork:
ColumbiaUniversityPress.
191
192 / Bibliography
Cammann, Schuyler. 1987. Symbolic Expression of YingYang Philosophy.In
ChineseIdeasaboutNatureandSociety, edited by Charles LeBlanc and Susan
Blader,10116.HongKong:HongKongUniversityPress.
Campany, Robert F. 2002. ToLiveasLongasHeavenandEarth:ATranslationand
StudyofGeHongsTraditionsofDivineTranscendents. Berkeley:University of
CaliforniaPress.
Carey,Benedict.2004.LongAfterKinsey,OnlytheBraveStudySex.NewYork
Times.November9.
Chan,AlanK.L.2002.AMatterofTaste:Qi(VitalEnergy)andtheTendingof
theHeart(Xin)inMencius2A2.InMencius:ContextsandInterpretations,ed
itedbyAlanK.L.Chan,4271.Honolulu:UniversityofHawaiiPress.
ChenHai .2004.GdianyuXiHannyongxingwanjukaoG
. Kaoguyuwenwu 3:6267.
Chen, Hsiufen.2003.Medicine, Society, andtheMaking ofMadnessin Impe
rialChina.Ph.D.Diss., UniversityofLondon,London.
Chen, Lei. 1995. Der Ahnenkult im alten China. InDas Alte China, edited by
PeterWiedehage,3644.Essen:KulterstiftungRuhr.
ChenYunhong.1995.SichuanHandaiGaoMeituhuaxiangzhuanchu
tan . Sichuanwenwu 1:1518.
Cline,Erin.2008.SpiritMediumshipandReligiousAuthorityinContemporary
Southeastern China. Paper Presented at the UBC Conference on Daoist
Studies,Vancouver
Creel,HerleeG. 1956.WhatIs Taoism?JournaloftheAmericanOrientalSociety
76.3:13952.
_____.1970. WhatisTaoism? Chicago:ChicagoUniversityPress.
Csikszentmihlyi Mark. 2009. Ethics and Selfcultivation Practice in Early
China. In Early Chinese Religion, edited by John Lagerwey and Marc
Kalinowski, 51942.Leiden:E. Brill.
Cullen, Christopher. 1996. Astronomy and Mathematics in Ancient China: The
Zhoubisuanjing.Cambridge:Cambridge University Press.
Danilou,Alian.1998. DerPhallus.Munich:Diederichs.
DeBernardi, Jean. 2006. The Way That Livesin the Heart: Chinese Popular Religion
andSpiritMediuminPenang, Malaysia.Stanford:StanfordUniversityPress.
DeWoskin,KennethJ.1983.Doctors, Diviner,andMagiciansofAncientChina:Biog
raphiesofFangshih.NewYork:ColumbiaUniversityPress.
Bibliography / 193
Despeux,Catherine.2001. TheSystemoftheFiveCirculatoryPhasesandtheSix
Seasonal Influences. In Innovationin ChineseMedicine, edited by Elisabeth
Hsu,12165.Cambridge:CambridgeUniversityPress.
_____. 1990. Immortelles de la Chine ancienne. Taosme et alchimie feminine. Paris:
Pardes.
_____.1989.Gymnastic:TheAncientTradition.InTaoistMeditationandLongev
ity Techniques, edited by Livia Kohn, 22561. Ann Arbor: University of
Michigan,CenterforChineseStudies.
_____ and Livia Kohn. 2003. WomeninDaoism. Cambridge, Mass.: Three Pines
Press.
DiagramGroup.1998. WomansBody.Ware:Wordsworth.
Diktter,Frank.1995.Sex,CultureandModernityinChina.London:Hurst&Co.
Ding,Naifei. 2002.ObsceneThings:SexualPoliticsinJinPingMei. Durham: Duke
UniversityPress.
Dobson,W.A.C.H.1973. ADictionaryofChineseParticles.Taipei:DoubleLeaves.
Dreger,AliceD.2000.HermaphroditesandtheMedicalInventionofSex.Cambridge,
Mass.:HarvardUniversityPress.
DuanYishan.2001.SuwenQuanYuanqibenyanjiuyujifu
.Shanghai:Shanghaikexuejishu.
East Asian Medical Studies Society. 1985. Fundamentals of Chinese Medicine.
Brookline:ParadigmPublications.
Eberhard,Wolfram.1972. ChineseFestivals.Taipei:TheOrientCulturalService.
_____.1968. TheLocalCulturesofSouthandEastChina.Leiden:E.Brill.
_____.1967. GuiltandSininTraditionalChina.Taipei:RainbowBridgeBookCo.
Engelhardt,Ute. 2001.Qifor Life: Longevity in the Tang. InTaoistMeditation
andLongevityTechniques,editedbyLiviaKohn,26398.AnnArbour:Univer
sityofMichigan, CenterforChineseStudies.
_____.2000.LongevityTechniquesandChineseMedicine. InDaoismHandbook,
editedbyLiviaKohn,74108. Leiden:E.Brill.
_____. 1996. Zur Bedeutung der Atmung im Qigong. Chinesische Medizin
1/1996:1723.
_____, and CarlHermann Hempen. 1997. ChinesischeDitetik.Munich: Urban &
Schwarzenberg
194 / Bibliography
Eggebrecht, Arne, ed. 1994. ChinaEine Wiege der Weltkultur: 5000 Jahre
ErfindungenundEntdeckung.Mainz:PhilippvonZabern.
Ellis,Andrew,NigelWisemanandKenBoss.1989.GraspingtheWind.Brookline:
ParadigmPublications.
Enzinger,Irmgard.2006.AusdruckundEindruck:ZumchinesischenVerstndnisder
Sinne. Wiesbaden:Harrassowitz.
Eskildsen,Stephen.1998.AsceticisminEarlyTaoistReligion.Albany:StateUniver
sityofNewYorkPress.
Evans,Harriet.1997. WomanandSexualityinChina.NewYork:Continuum.
Fang,FuRuan.1991. SexinChina.NewYork:Plenum Press.
Farquhar, Judith. 2002. Appetites: Food and Sex in Postsocialist China. Durham:
DukeUniversityPress.
_____.1994.KnowingPractice:TheClinicalandCounterofChineseMedicine.Boulder:
Westview.
FengXiuqi.1995.Sangjianyehe huaxiangzhuankaoshi
.Sichuanwenwu 3:6062.
Finsterbusch, Kate.2004. VerzeichnisundMotivindexderHanDarstellungen. Band
IV: AbbildungenundAddenda. 2vols.Wiesbaden:Harrassowitz.
Fishlen, Michael. 1994. Wine, Poetry and History: Du Mus Pouring Alone in
thePrefecturalResidence. ToungPao 80:26097.
Franchimont,Paul,AndreDemoulin,andJ.P.Bourguignon.1986.Regulationof
Gonadotropin Secretion. In Male ReproductiveDysfunction,edited by Rich
ardJ.SantenandRonaldS.Swerdloff,10126. NewYork:MarcelDekker.
Franke, Herbert. 1984. Chinesische erotische Literatur. InNeuesHnadbuchder
Literaturwissenschaft: OstasiatischeLiteraturen, edited by Gnther Debon, 99
106. Wiesbaden:Aula.
Franzblau, AbrahamN.,and Etiemble Franzblau. 1977.EroticArtofChina.New
York:CrownPublishers.
Fruehauf,Heiner.1999.ChineseMedicineinCrisis.JournalofChineseMedicine
61:614.
Fung, Yulan. 1952. A History of Chinese Philosophy. Translated by Derk Bodde.
Princeton:PrincetonUniversityPress.
Furth, Charlotte. 1999. A Flourishing Yin: Genderin ChinasMedicalHistory, 960
1665.Berkeley:UniversityofCaliforniaPress.
Bibliography / 195
_____. 1994. Rethinking Van Gulik: Sexuality and Reproduction in Traditional
Chinese Medicine. In Engendering China: Women, Cultureandthe State, ed
ited by Christina K. Gilmartin et al., 12546. Cambridge, Mass.: Harvard
UniversityPress.
Gao Shishi .2001.HuangdineijingSuwenzhijie. Beijing:
Xueyuan.
GaoWen .1995. Yehetukao. Sichuanwenwu 1:1920.
Goldin,PaulRakita.2002.TheCultureofSexinAncientChina.Honolulu:Univer
sityofHawaiiPress.
Graham,A.C.2003.DisputersoftheTao:PhilosophicalArgumentinAncientChina.
Chicago:OpenCourt.
_____.1986.YinYangandthe NatureofCorrelativeThinking.Singapore:Instituteof
EastAsianPhilosophies.
_____.1981.Chuangtzu:TheSevenInnerChaptersandOtherWritingsfromtheBook
of Chuangtzu.London:Allan&Unwin.
_____.1978.LaterMohistLogic,EthicsandScience.HongKong:ChineseUniversity
Press.
Grant,Joanna. 2003.AChinesePhysician:WangJiandtheStoneMountainMedical
CaseHistories.London:RoutledgeCurzon.
GuoAichun.1999a.HuangdineijingSuwenjiaozhuyuyi
.Tianjin:Tianjinkexuejishu.
_____.1999b.HuangdineijingLingshujiaozhuyuyi.Tianjin:
Tianjinkexuejishu.
Hanson,Marta.2001.Robust Northerners and DelicateSouthereners:The 19th
centuryInventionofaSouthernMedicalTradition.InInnovationinChinese
Medicine, edited by Elisabeth Hsu, 26291. Cambridge: Cambridge Univer
sityPress.
Harbsmeier,Christoph.1995.EroticisminEarlyChinesePoetry.InDasandere
China, editedbyHelwigSchmidtGlintzer,32380.Wiebaden:Harrassowitz.
Harper,Donald2005.AncientandMedievalChineseRecipesforAphrodisiacs
andPhilters.AsianMedicine:TraditionandModernity 1.1:91100.
_____.2001. Iatromacy,Diagnosis,andPrognosisinEarlyChineseMedicine. In
InnovationinChineseMedicine, edited by Elisabeth Hsu, 99119.Cambridge:
CambridgeUniversityPress.
196 / Bibliography
_____. 1998. Early Chinese Medical Literature. New York: Columbia University
Press.
_____.1977.TheSexualArtsofAncientChinaasDescribedinaManuscriptof
theSecondCenturyBC. HarvardJournalofAsianstudies51.4:53993.
He,Zhiguo,andVivienneLo.1996.TheChannels:APreliminaryExamination
ofaLacqueredFigurinefromtheWesternHan.EarlyChina 21:81123.
Hebei yixueyuan , ed. 1982. Lingshu jing jiaoshi . Beijing:
Renminweisheng.
Hempen, CarlHermann. 2000. DTVAtlas Akupunktur. Munich: Deutscher Ta
schenbuchVerlag.
Hentze, Carl. 1951. Bronzegert, Kultbauten, Religion im ltesten China der Shang
Zeit, Band1.Antwerpen:DeSikkel.
Hertzer,Dominique.2006.DasLeuchtendesGeistesunddieErkenntnisderSeele:Die
medizinischeVorstellungvomSeelischenalsAusdruckphilosophischenDenkens
ChinaunddasAbendland.Frankfurt:VerlagfrAkademischeSchriften.
_____.2009.VonderKunst,Schafezuhten:DiePrinzipienderLebenspflege,
Yangsheng. WenWu: ZeitschriftfrchinesischeKulturundKampfkunst 2:1820.
Hines, Terence. 2001. The Gspot: A Modern Gynecological Myth. American
JournalofObstetrics&Gynecology185.2:359362.
Hinsch,Bret.2002. WomeninEarlyImperialChina.Lanham:Rowman&Littlefield.
_____. 1990. Passion of the Cut Sleeve: The Male Homosexual Tradition in China.
Berkeley:UniversityofCaliforniaPress.
Hsia,EmilC.H.,IlzaVeith,andRobertH.Geertsma.1986.TheEssentialofMedi
cineinAncientChinaandJapan.Leiden:E.Brill.
Hsu,Elisabeth,ed.2001a.InnovationinChineseMedicine.Cambridge:Cambridge
UniversityPress.
_____.2001b.PulseDiagnosticsintheWesternHan:How maiandqiDetermine
bing.InInnovationinChineseMedicine,editedbyElisabethHsu,5191.Cam
bridge:CambridgeUniversityPress.
_____,1999.TheTransmissionofChineseMedicine.Cambridge:CambridgeUniver
sityPress.
_____. 1996. Innovations in Acumoxa: Acupuncture Analgesia, Scalp and Ear
Acupuncture in the Peoples Republic of China.SocialScienceandMedicine
42.3:42130.
Bibliography / 197
_____.1995.TheManikininMan:CultureCrossingandCreativity.InSyncre
tism and the Commerce of Symbol, edited by G. Aijmer, 156213. Gteborg:
IASSA.
Huang, HsingTsung. 2000.FermentationandFoodScience.InScienceandCivilisa
tioninChina,vol.VI,part5.Cambridge:CambridgeUniversityPress.
Hulsew,A. F. P. 1993. Hanshu.InEarlyChineseTexts:ABibliographicalGuide,
edited by Michael Loewe, 12936. Berkeley: Society for the Study of Early
China.
Hunansheng bowuguan .1974.ChangshaMawangdui ersan hao
Han mufajuejianbao. Wenwu 7:3948.
Ishihara,Akira,andHowardS.Levy.1968.The TaoofSex.Yokohama:Shibundo.
Jackowicz,Stephen.2011.DaoistIncantationsforAcupunture.JournalofDaoist
Studies 4:6581.
Jefferys,Elaine.2006. Sex andSexuality inChina.London:Routledge.
Kalinowski,Marc.2004.TechnicalTraditionsinAncientChinaandShushuCul
ture in Chinese Religion.InReligionandChineseSociety:AncientandMedie
valChina,VolumeI, edited by John Lagerwey, 22348.Hong Kong: Chinese
UniversityPress.
Kapac, Jack Steven. 1992. Chinese Male Homosexuality: Sexual Identity Formation
andGayOrganizationalDevelopmentinaContemporaryChinesePopulation.Ann
Arbor:UniversityofMichigan,CenterforChinestStudies.
Kaptchuk,Ted.2000.TheWebthatHasNoWeaver:UnderstandingChineseMedicine.
NewYork:Congdon&Weed.
_____.1993. DasGroeBuchderChinesischenMedizin. Bern:WilhelmBarth.
Karacan,Ismet,andConstanceA.Moore.1986.ObjectiveMethodsofDifferen
tiation between Organic and Psychogenic Impotence.InMaleReproductive
Dysfunction, edited by Richard J. Santen and Ronald S. Swerdloff, 54562
NewYork:MarcelDekker.
Karlgren,Bernhard.1930.SomeFecunditySymbolinAncientChina.Bulletinof
the MuseumofFarEasternAntiquities2:154.
Keegan,DavidJoseph.1988.TheHuangtineiching:TheStructureoftheCompila
tionTheSignificanceoftheStructure.Ph. D. Diss.University of California,
Berkeley.
Keightley, David. 1999.The Shang: Chinas First Historical Dynasty.In Cam
bridgeHistoryofAncientChina:FromtheOriginofCivilisationto221BC,edited
198 / Bibliography
by Michael Loewe and Edward S. Shaaughnessy, 23291. Cambridge:
CambridgeUniversityPress.
KennerknechtHirth,MariaM.2009.AnatomieinChina:EinberblickvonderHan
biszurQingZeit. Munich:Martin Meidenbauer.
Kessler Suzanne J. 1998. Lessons from the Intersexed. New Brunswick: Rutgers
UniversityPress.
Kinsey,A.1953. SexualBehaviorinthe HumanFemale.Philadelphia:Saunders.
KinseyInstitute: http://www.kinseyinstitute.org/library/suepian.html.
Kirkland, Russel. 2007.FangzhongshuArts oftheBedchamber: Sexual
Techniques. In The Encyclopedia of Taoism, edited by Fabrizio Pregadio,
1:40911. London:Routledge.
Kirschbaum, Barbara. 1995. Die acht auerordentlichen Gefe in der traditionellen
chinesischenMedizin.Uelzen:MedizinischLiterarischeVerlagsgesellschaft.
Klein,Heinz.1988.DictionaryofDifficulttoExplainWordsintheHuangdiNeijing.
Taipei:Wenguangtushuyouxiangongsi.
Kleinman, Arthur. 1980. Patients and Healers in the Context of Culture. Berkeley:
UniversityofCaliforniaPress.
Klinke, Rainer, and Stefan Silbernagl. 1996. Lehrbuch der Physiologie. Stuttgart:
GeorgThieme.
Knechtges, David R. 2002. Court Culture and Literature in Early China. Surrey:
AshgatePublishing.
Kohn, Livia. 2010a. Daoist Dietetics: Food for Immortality. Dunedin, Fla.: Three
PinesPress.
_____. 2010b. Sitting in Oblivion: The Heart of Daoist Meditation. Dunedin, Fla.:
ThreePinesPress.
_____.2008. ChineseHealingExercises:TheTraditionofDaoyin.Honolulu: Univer
sityofHawaii Press.
_____. ed. 2006. DaoistBodyCultivation:TraditionalModelandContemporaryPrac
tices.Magdalena:ThreePinesPress.
_____.2001. DaoismandChineseCulture.Cambridge,Mass.:ThreePinePress.
_____,ed.2000. DaoismHandbook.Leiden:E.Brill.
_____, ed. 1989a. TaoistMeditationandLongevityTechniques.Ann Arbor: Univer
sityofMichigan,CenterforChineseStudies.
Bibliography / 199
_____.1989b.TaoistInsightMeditation:TheTangPracticeofNeiguan. InTaoist
MeditationandLongevityTechniques,editedbyLiviaKohn,193224.AnnAr
bor:UniversityofMichigan,CenterforChineseStudies.
_____,andRobinR.Wang,eds.2009.InternalAlchemy:Self, Society,andtheQuest
forImmortality. Magdalena,NM:ThreePinesPress.
Kuriyama, Shigehisa. 1999. The Expressiveness of the Body and the Divergence of
GreekandChineseMedicine.NewYork:ZoneBooks.
Ladas, Alice Kahn, Beverly Whipple, and John D. Perry. 1982. The GSpot and
Other Discoveries about Human Sexuality. New York: Holt, Rinehart and
Winston.
Lai,Chuhui Judy. 1991. TheHanRepresentationofExemplaryWoman:Contextand
Interpretation.AnnArbor:UniversityofMichigan,CenterforChineseStud
ies.
Larre,Claude.1994. TheWayofHeaven.Cambridge:MonkeyPress.
_____, Elisabeth Rochat De La Valle, and Caroline Root. 1996. The SevenEmo
tions:PsychologyandHealthinAncient China. Cambridge: MonkeyPress.
Lau,D.C.1984. Mencius.HongKong:ChineseUniversityPress.
Legge, James. 1985. The ChineseClassics.Volume 5: TheChunTsewwiththeTso
Chuen,Taipei:SouthernMaterialCentre.
Li, Huarui. 1995. On the Origin of Alcohol in China. Social Sciences in China
16.4:93100.
Li,Ling.1993.Zhongguofangshukao.Beijing:RenminZhongguo
chubashe.
_____.1992. GaoLuopeiyuMawangduifangzhongshu.
In Mawangdui Hanmu yanjiu wenji . Changsha: Hunan
chubanshe.
_____,andKeithMcMahon.1992.TheContentsandTerminologyofMawang
duimanuscriptsontheArtsoftheBedchamber.EarlyChina 17:14585.
Li,Zhaoguo. 2005.YellowEmperorsCanonofMedicine:PlainConversation.
Xian:WorldPublishingCorporation.
LiShizhen .1994[firstpublishedin1596].Bencaogangmu .Beijing:
Zhongyigujichubanshe.
Li,Zhulanet al.1990.The EnglishChineseEncyclopaediaofPracticalTradi
tionalChineseMedicine:Gynaecology. Beijing:HigherEducationPress.
200 / Bibliography
Lim,Lucy.1987.StoriesfromChinasPast.SanFrancisco:ChineseCulturalFoun
dationofSanFrancisco.
Liu, Chengcai, et al., eds. 1991. EssentialsofTraditionalChineseMedicine. Beijing:
HigherEducationPress.
Liu Dalin . 1993. Zhongguo gudai xingwenhua . Yinchuan:
Renmin.
_____,etal.1997.SexualBehaviorin ModernChina:ReportontheNationwide Survey
of20,000 Menand Women.NewYork:Continuum.
Liu, James J. Y. 1962. The Art of ChinesePoetry. Chicago: University of Chicago
Press.
Liu,Xun.2009.NuminousFatherandHolyMother:LateMingDuoCultivation
Practice. In Internal Alchemy: Self,Society,and theQuest forImmortality, ed
itedbyLiviaKohnandRobinR.Wang,12241.Magdalena,NM:ThreePines
Press.
Liu, Yutan et al. 1991.The EnglishChineseEncyclopaediaofPracticalTradi
tional Chinese Medicine:Therapeuticsof Acupuncture andMoxabustion. Beijing:
HigherEducationPress.
Lo,Vivienne.2010. HealingArtsinEarlyChina.Leiden:E.Brill.
_____. 2001. The Influence of Nurturing Live Culture on the Development of
Western Han Acumoxa Therapy.In Innovationin ChineseMedicine, edited
byElisabethHsu,1950.Cambridge:CambridgeUniversityPress.
_____.2005.QuickandEasyMedicine:TheDunhuangmoxibustioncharts.In
Medieval Chinese Medicine: The Dunhuang Medical Manuscripts, edited by
VivienneLo andChristopherCullen,22751.London:RoutledgeCurzon.
Lloyd, ElisabethAnne. 2005.The Caseofthe FemaleOrgasm:Biasinthe Scienceof
Evolution. Cambridge,Mass.:HarvardUniversityPress.
Lu, GweiDjen. 1980. Celestial Lancets: A History and Rational Acupuncture and
Moxa.Cambridge:CambridgeUniversityPress.
_____. 1975. Problems of Translation and Modernisation of Ancient Chinese
TechnicalTerms. AnnalsofScience 32.
Lu,HenryC.1978.ACompleteTranslationof theYellowEmperorsClassicofInternal
Medicineand theDifficultClassic.Vancouver:TheAcademyofOrientalHeri
tage.
Lu,Xing.1998.RhetoricinAncientChina,FifthtoThirdCenturyBCE:AComparison
withClassicalGreekRhetoric.Columbia:UniversityofSouthCarolinaPress.
Bibliography / 201
Luo,Xiwen.2003.CompendiumofMateriaMedica:Bencaogangmu.Beijing:Foreign
LanguagesPress.
Luria,Zella,andMichelD.Rose.1979.PsychologyofHumanSexuality.NewYork:
Wiley.
Lutz,Albert,ed.1986.Dian:EinVersunkenesKnigreichinChina.Zrich:Museum
RietbergZrich.
Ma, Chengyuan. 1986. Ancient Chinese Bronzes. Hong Kong: Oxford University
Press.
MaJixing.1992.Mawangduiguyishukaoshi.Changsha:
Hunankexuejishuchubanshe.
Ma,Kanwen.1989.ClassicChineseMedicalLiteratureinContemporaryChina:
Texts Selected for Modern Editions, and Problems Associated with this
Work.InApproachestoTraditionalChineseMedicalLiterature, edited by Paul
Unschuld,718.Dordrecht:KluwerAcademicPublishers.
MaShi.1998[1586].HuangdineijingSuwenzhuzhengfawei
.Beijing:Renminweisheng.
Maciocia, Giovanni. 1998. Obstetrics and Gynaecology in Chinese Medicine. New
York:ChurchillLivingston.
_____.1994. The PracticeofChineseMedicine.London:ChurchillLivingston.
_____.1989. TheFoundationsofChineseMedicine.London:ChurchillLivingston.
Mackenzie,DonaldA.n.d.. MythsofChinaandJapan.London:Gresham.
Major,JohnS.,SarahA.Queen,AndrewS.Meyer,andHaroldD.Roth.2010.The
Huainanzi:AGuidetotheTheoryandPracticeofGovernmentinEarlyHanChina.
NewYork:ColumbiaUniversityPress.
Makeham,John.1996. TheFormationoftheLunyu asaBook. MonumentaSerica
44:124.
Margulis, Lynn, and Dorion Sagan. 1997. What Is Sex? New York: Simon &
Schuster.
Maspero,Henri.1981.TaoismandChineseReligion.Amherst:UniversityofMassa
chusettsPress.
Masters,WilliamH.,andVirginiaE.Johnson.1966.HumanSexualResponse.Lon
don:J.A.Churchill.
Mawangdui Han mu boshu zhengli xiaozu , ed. 1980.
Mawnagdui Han muboshu ,vol.I.Beijing:Wenwu.
202 / Bibliography
_____.1985. Mawangdui Han muboshu ,vol.IV.Beijing:Wenwu.
McKnight Brain E.,trans.1981.TheWashingAwayofWrong:ForensicMedicinein
ThirteenthcenturyChina.AnnArbor:UniversityofMichigan,CenterforChi
neseStudies.
McMahon, John Michael. 1993. Representing Impotence: Systems of Belief in
AncientPopularCulture.Ph.D.Diss.UniversityofPennsylvania,Philadel
phia.
Middendorf, Ulrike. 2007. Resexualizing the Desexualized: The Language of Desire
andErotic LoveintheClassicofOdes.Pisa:AccademiaEdioriale.
_____. 2004. Digging Out New Meaning: On Methodological Uses of Wen
YiduosShijingandChuciCommentaries.InPoet,Scholar,Patriot,editedby
HansPeterHoffmann,20533.Bochum:Project.
Milsky,Constantin.1989.InSearchofaTermTranslationStrategyforChinese
Medical Classics.In ApproachestoTraditionalChineseMedicalLiterature, ed
itedbyPaulU.Unschuld,7781.Dordrecht:KluwerAcademicPublishers.
Mitamura,Taisuke.1970.ChineseEunuchs.Rutland,VT:CharlesE.Tuttle.
Mitchell, Craig, Feng Ye, and Nigel Wiseman. 1999. Shang Han Lun: On Cold
Damage.Brookline:ParadigmPublications.
Mote,FederickW.1977.YanandMing. InFoodinChineseCulture,editedbyC.
K.Chang,193258.NewHaven:YaleUniversityPress.
Moore,KeithL.1980.Embryologie.Stuttgart:F.K.Schattauer.
Muenstenberger, Warner. 1969. Orality and Dependence: Characteristics of
Southern Chinese.InManandHisCulture:PsychoanalyticAnthropologyafter
TotemandTaboo,editedbyWarnerMuenstenberger,295329.London:Rapp
&Whiting.
Munro, Donald J. 1988. Images of Human Nature: A Sung Portrait. Princeton:
PrincetonUniversityPress.
MurakamiYoshimi .1988.KteinaikydaisotoDkashis
. Th shky 71:119.
Murat, W. von, ed. 1984. Sue pien: Ein chinesisches erotisches Abbildungswerk.
FaksimiledesMingDrucks. Hamburg:C.Bell.
Needham, Joseph, et al. 1956. Science and Civilisation in China, vol. II: History of
ScientificThought.Cambridge:CambridgeUniversityPress.
______.1959.ScienceandCivilisationinChina,vol.III:MathematicsandtheSciences
oftheHeavensandtheEarth.Cambridge:CambridgeUniversityPress.
Bibliography / 203
______. 1983. Science and Civilisation in China, vol. V.5: Spagyrical Discovery and
InventionPhysiologicalAlchemy.Cambridge:CambridgeUniversityPress.
Nguyen, Van Nghi. 1996. Hoang Ti Nei Ki So Ouenn. Uelzen: Medizinisch
LiterarischeVerlagsgesellschaft.
Ni,Maoshing.1995. TheYellowEmperorsClassicofMedicine. Boston:Shambahla.
Nickerson, Peter. 2000. The Southern Celestial Masters. In Daoism Handbook,
editedbyLiviaKohn,25682.Leiden:E.Brill.
Nogier,Paul.2008. Auriculotherapy. Stuttgart:Thieme.
OHara, Albert Richard. 1978. The PositionofWomeninEarlyChina:Accordingto
the Lien zhuan.Taipei:MaiYa.
OldstoneMoore, Jennifer. 2003. Confucianism. In Alcohol and Temperance in
Modern History: An International Encyclopaedia, edited by Blocker Jack S.,
DavidM.FaheyandIanR.Tyrrell,1:17071.SantaBarbara:ABCCLIO.
Oudshoorn,Nelly.1994.BeyondtheNaturalBody:AnArchaeologyofSexHormones.
London:Routledge.
Owen, Stephen. 2001.Reproduction in the Shijing(Classicof Poetry).Harvard
JournalofAsiatic Studies 61.2:287315.
Peerenboom,R.P.1993.LawandMoralityinAncientChina:TheSilkManuscriptsof
HuangLao.Albany:StateUniversityofNewYorkPress.
Pfister, Rodo. 2011. Sexuelle Krpertechniken im alten China. 3 vols. Norderstedt:
BooksOnDemand.
_____. 2007. Der Milchbaum und die Physiologie der weiblichen Ejakulation:
BemerkungenberPapiermaulbeerundFeigenbumeimSdenAltchinas
(TheMilkTreeandthePhysiologyofFemaleEjaculation).AsiatischeStudien
61.3:81344.
_____.2003. DerbesteWegunterdemHimmel.Zrich:MuseumReitberg.
_____.1997.SexuelleKrpertechnikenindenmedizinischenManuskriptenaus
Mawangdui.AsiatischeStudien 51.4:103946.
Porkert, Manfred. 1974. Theoretical Foundations of Chinese Medicine. Cambridge,
Mass:MITPress.
_____.1975.TheDilemmaofPresentdayInterpretationsofChineseMedicine.
InMedicineinChineseCulture,editedbyArthurKleinmanetal.,6175.Wash
ington,D.C.:USDepartmentofHealth,Education,andWelfare.
204 / Bibliography
_____, CarlHermann Hempen,and ChinaAcademy. 1995.ChineseAcupuncture:
The StandardTextbook.Dinkelscherben:PhainonEditions.
Qin Liyi , ed. 1989. Shang Zhou qingdong jiuqi . Taipei:
Gugongbowuguan.
Raphal,Lisa.1998. Sharing theLight.Albany:StateUniversityofNewYorkPress.
Rawson,Jessica.1996. MysteriesofAncientChina. London:BritishMuseum.
_____.1995.DierituellenBronzegefederShangundZhouPerioden.InDas
alteChina, editedbyRogerGpper, 7694. Essen:KulturstiftungRuhr.
Raz, Gil. 2008. The Way of the Yellow and the Red: Reexamining the Sexual
Initiation Rite of CelestialMaster Daoism.Nann:Men,WomenandGender
inChina 10:86120.
Read,BernardE.1977.ChineseMateriaMedica:AvianDrugs.Taipei:SouthernMa
terialCentre.
Ren Yingqiu . 1986. Huangdi neijing zhangju suoyin .
Beijing:Renmin.
Rickett, Allyn W. 1965. KuanTzu: A Repository of Early Chinese Thought. Hong
Kong:HongKongUniversityPress.
Riegel,Jeffrey.1997.Eros,Introversion,andtheBeginningsofShijingCommen
tary. HarvardJournalofAsianStudies57.1:14377.
_____. 2000. The Zuozhuan Lecture of Physician He on Passion and Disease.
PaperPresentedattheConferenceonChineseCommentariesintheUni
versityof Heidelberg.
Robinson, Douglas. 2001. Who Translates? Translator Subjectivities Beyond Reason.
Albany:StateUniversityofNewYorkPress.
Robinson,Kenneth.2004.ScienceandChineseSociety, vol.VII.7:GeneralCondusions
andReflecitons.Cambridge:CambridgeUniversityPress.
Robinet, Isabelle. 1993. Taoist Meditation: The Maoshan Tradition of Great Purity.
Translatedby JulianF.PasandNormanJ.Girardot.Albany:StateUniversity
ofNewYorkPress.
_____.1989.OriginalContributionofNeidantoTaoismandChineseThought.
InTaoistMeditationandLongevityTechniques, edited by LiviaKohn, 297330.
AnnArbor:UniversityofMichigan,CenterforChineseStudies.
Rochat, de la Vallee. 1989. Obstacles to Translating Classical Chinese Medical
TextstoWesternLanguages.InApproachestoTraditionalChineseMedicalLit
Bibliography / 205
erature, edited by Paul U. Unschuld, 6776. Dordrecht: Kluwer Academic
Publishers.
Roth, Harold D. 1999. Original Tao:InwardTraining and theFoundationsof Taoist
Mysticism.NewYork:ColumbiaUniversityPress.
Ruan,Fangfu.1991.SexinChina:StudiesinSexologyinChineseCulture.NewYork:
PlenumPress.
_____. 1997. China. InSociolegalControlofHomosexuality:AMultiNationCom
parison,editedbyDonaldJamesWestandRichardGreen,5766.NewYork:
Plenum Press.
Rusbridger, Alan. 1986. A ConciseHistory of the SexManual18861986. London:
Faber&FaberLimited.
Ryden,Edmund.1997.TheYellowEmperorsFourCanons.Taipei:KuangchiPress.
Sakade,Yoshinobu.2007.TaoismandMythology:Pengzu.InTheEncyclopedia
ofTaoism,editedbyFabrizioPregadio,79091.London:Routledge.
_____. 1989. Longevity Techniques in Japan: Ancient Sources and Contempo
rary Studies. In TaoistMeditation andLongevity Techniques, edited by Livia
Kohn,140.AnnArbor:UniversityofMichigan,CenterforChineseStudies.
_____.ed.1988.Chgokukodaiyseishisnosgtekikenky
.Tokyo:Hirakawa.
Schiavi, Raul C., and Jamil Rehman. 1995. Impotence, Sexuality and Aging.
UrologicalClinicsofNorthAmerica 22.4:71126.
Schilling,Dennis.2009. YijingDasBuchderWandlungen. Frankfurt:Suhrkamp.
Schipper,Kristofer.1993.TheTaoistBody.Berkeley:UniversityofCaliforniaPress.
_____. 1969.Science,Magic,andMystique ofthe Body.In The Cloudsandthe
Rain (The Art of Love in China), edited by Michel Beurdeley, 538. London:
Hammond&Co.
Schmidt,WolfgangG.A.1993.DerKlassikerdesGelbenKaiserszurInnerenMedizin.
Freiburg:Herder.
Schuster,Carlotta.1988.AlcoholandSexuality.NewYork:PraegerPublishers.
Schwartz, Benjamin I. 1985. The World of Thought in Ancient China. Cambridge,
Mass.:HarvardUniversityPress.
Scruton, Roger. 1986. Sexual Desire: A Philosophical Investigation. London: Wei
denfeld&Nicolson.
206 / Bibliography
SeattleArtMuseum.2001.AncientSichuanTreasuresinaLostCivilisation.Seattle:
SeattleArtMuseum.
Shandong&HebeiMedicalSchools,eds.1995.Huangdineijingsuwenjiaoshi
Shanghai College. 1990. Basic Theory of Traditional Chinese Medicine. Shanghai:
ShanghaiCollegeofTraditionalMedicine.
Sivin,Nathan. 1995.Medicine,PhilosophyandReligioninAncientChina:Researches
andReflections.London:Variorum.
______. 1993. Huangti neiching. In Early Chinese Texts: A Bibliographical Guide,
edited byMichael Loewe, 196215. Berkeley:Societyfor the Study of Early
China.
______. 1987. TraditionalMedicineinContemporaryChina. Ann Arbor: University
ofMichigan,CenterforChineseStudies.
_____,andLuGweiDjen.2000.ScienceandCivilisationinChina,vol.VI.6:Biology
andBiologicalTechnology.Cambridge:CambridgeUniversityPress.
Skar,Lowell,andFabrizioPregadio.2000.InnerAlchemy(Neidan).InDaoism
Handbook,editedbyLiviaKohn,46497.Leiden:E.Brill.
Smith, Tony, ed. 1990.CompleteFamilyHealthEncyclopaedia.London: Guild Pub
lishing.
Song Yuanru,ed.2004.Xian beijiaoMingzhuxin jiayuanM54 fajue ji
anbao M54 . In Kaogu yu wenwu
2:1519.
Spence, Jonathan. 1977. Ching. In Food in Chinese Culture, edited by C. K.
Chang,25994. NewHaven,Conn.:YaleUniversityPress.
Stein, Stephan. 1999. Zwischen Heil und Heilung: Zur frhen Tradition des
YangshenginChina. Uelzen:MedizinischLiterarischeVerlagsgesellschaft.
Sterckx, Roel. 2005. Food and Philosophy in Ancient China. In Of Tripod and
Palate:Food,PoliticsandReligioninTraditionalChina, edited by Roel Sterckx,
3461.NewYork:PalgraveMacMillan.
Stone,CharlesR.2003.TheFountainheadofChineseErotica:TheLordofPerfectSat
isfaction(Ruyijunzhuan).Honolulu:UniversityofHawaiiPress.
Strickmann,Michel.2002.ChineseMagicalMedicine.Stanford:StanfordUniversity
Press.
Bibliography / 207
Syed, Renate. 1999. Zur Kenntnis der GrfenbergZone und der weiblichen
Ejakulation in der altindischen Sexualwissenschaft.SudhoffsArchiv83:171
90.
Tamba no Matoyasu . 1959. Somon shiki . In Huanghan yixue
congshu ,vol.1.Beijing:Renmin.
Tessenow,Hermann.2002.TheHuangDiNeiJingProject:MethodologyofStyle
Analysis.AsiatischeStudien/EtudesAsiatiques LVI.3:64758.
_____,andPaulU.Unschuld.2008.ADictionaryof theHuangDiNeiJingSuWen.
Berkeley:UniversityofCaliforniaPress.
Tsai, Shihshan Henry. 1996. The Eunuchs in the Ming Dynasty. Albany: State
UniversityofNewYorkPress.
Tungtsu Ch. 1972. Han Social Structure. Seattle: University of Washington
Press.
Twitchett, Denis, andMichael Loewe, eds. 1986. The CambridgeHistoryof China,
Vol.1: The Chin and Han Empires,221BCAD220. Cambridge: Cambridge
UniversityPress.
Umekawa,Sumiyo.2005.Tiandiyinyangjiaohuangdalefuandtheartofthebed
chamber. In Medieval Chinese Medicine: The Dunhuang medical manuscripts,
edited by Vivienne Lo and Christopher Cullen, 25277. London: Routledge
Curzon.
_____. 2003. Transmission of Sexual Positioning in Relationship with Female
Orgasm. Paper Presented at the Asian Society for History of Medicine:
SymposiumontheHistoryofMedicineinAsia.London.
Unschuld,PaulU.2003.Huangdineijingsuwen:Nature,Knowledge,Imageryinan
AncientChineseMedicalText.Berkeley:UniversityofCaliforniaPress,
_____,trans.1986.NanChing:TheClassicofDifficultIssues.Berkeley:Universityof
CaliforniaPress.
_____.1985.MedicineinChina:AHistoryofIdeas.Berkeley:UniversityofCalifor
niaPress.
_____.1982. DerWindalsUrsachedesKranksein.ToungPao 63:13.
VanGulik,R.H.2004.EroticColorPrintsoftheMingPeriod:withanEssayonChi
neseSexLifefromtheHantotheChingDynasty,BC.206A.D.1644.Leiden:E.
Brill.
_____.1961. SexualLifeinAncientChina. Leiden:E.Brill.
208 / Bibliography
Veith, Ilza. 1966. TheYellowEmperorsClassicofInternalMedicine. Berkeley: Uni
versityofCaliforniaPress.
Wagner,Grom,andSorenBuusJensen.1981.AlcoholandErectileFailureinImpo
tence: Physiological,Psychological, Surgical Diagnosis and Treatment, edited by
WagnerGromandRichardGreen.NewYork:PlenumPress.
Waley,Arthur,trans.1956.TheWayandItsPower.London:GeorgeAllen&Un
win..
_____.1937.TheBooksofSongs.London:GeorgeAllen&Unwin.
_____. 1931.MagicalUse of Phallic Representations: Its latesurvival in China
andJapan.Bulletin ofthe MuseumofFarEasternAntiquities 3:6168.
Wang, Hongtu . 1999. Diseases, Symptoms and Clinical Applications of the
YellowEmperorsCannononInternalMedicine. Beijing:NewWorldPress.
_____ et al. 1997. Huangdineijing yanjiudacheng . Beijing: Bei
jingchubanshe.
Wang Maohe . 1992. Zhongguo yangsheng baodian . Beijing:
Zhongguoyiyaokeji.
Wang,RobinR.(ed.).2003.ImagesofWomeninChineseThoughtsandCulture:Writ
ingfromthePreQinPeriodthroughtotheSong.Indianapolis:HackettPublish
ingCompany,Inc.
Watson, Burton. 1968. The Complete Works of Chuangtzu. New York: Columbia
UniversityPress.
_____. 1961.Recordsofthe GrandHistorianofChina:TranslatedfromtheShihchiof
SsuMaChien.NewYork:ColumbiaUniversityPress.
_____. 1958. SsuMa Chien GrandHistorian of China. New York: Columbia Uni
versityPress,
Weakland,JohnH.1956.OralityinChineseConceptionsofMaleGenitalSexu
ality. Psychiatry 19:23747.
Webster, Inc. 1993. Websters ThirdNewInternationalDictionary. Cologne: Kne
man.
Wile,Douglas.1992.ArtoftheBedchamber:TheChineseSexualYogaClassicsInclud
ing Womens Solo Meditation Texts. Albany: State University of New York
Press.
Wilhelm, Hellmut. 1950. The I Ching or Book of Changes, trl. Cary F. Baynes.
Princeton:PrincetonUniversityPress.
Bibliography / 209
_____.1948.EineZhouInschriftberAtemtechnik. MonumentaSerica13:38588.
Wiseman, Nigel and Ye Feng. 1998. A Practical Dictionary of Chinese Medicine.
Brookline:ParadigmPublications.
Wu,JingNuan.1993. LingShu:TheSpiritualPivot.Washington:TaoistCenter.
Wu,Nelson,andAndrewWu.1997.TheYellowEmperorsCanonofInternalMedi
cine.Beijing:ChinaScienceandTechnologyPress.
XiaNai etal.,ed.198688.Zhongguodabaikequanshu:Kaoguxue
: . Beijing:Zhongguodabaikequanshu.
Xie Li and Xu Lihong . 1992. Sichuan Hejiangxian Dong Han
zhuanshimu qingli jianbao . Wenwu
4:4548.
XinLili.1994.Huangdineijingzhongdeqisunbayikao
. Xinjiangzhongyiyao 3:611.
Yamada, Keiji. 1998. The Origins of Acupuncture, Moxibustion, and Decoction.
Kyoto:InternationalResearchCentreforJapaneseStudies.
_____.1991. Anatometricsin AncientChina.ChineseScience,10:3952.
_____.1979. TheFormationoftheHuangTiNeiChing. ActaAsiatica 36:6789.
YangAiguo.1994.Hanmuxiangshishangdejiewentukaobian
.Sichuanwenwu 4:2225.
YangFan.2002.MythsandRitualoftheYangtzeRiverCivilisation
.InDianqingtongwenhuadeqiyuan:niandaijiqichongbai
: ,editedby AntianXi . Beijing:Wenwu.
Yang,Shouzhong.1997. Maijing: VesselClassic.Boulder:BluePoppyPress.
Yimen.1997. DreamsofSpring:EroticArtinChina. Amsterdam:ThePepinPress.
Y,YingShih.1977.Han.InFoodinChineseCulture,editedbyC.K.Chang,53
83.NewHaven:YaleUniversityPress.
_____.196465.LifeandImmortalityintheMindofHanChina.HarvardJournal
ofAsianStudies 25:80122.
Zaroff, Lawrence. 1999.DemystifyingNonDevelopment:The Case of Surgery
inPreModernChina.JournalofChineseMedicine 59:1521.
ZengXiangwang.1993.Guixifaxiandegudaiyanhua
.Kaoguyuwenwu 6:113.
210 / Bibliography
Zhangjiashanzu.1990.ZhangjiashanHanjianyinshushiwen
. Wenwu 10:826.
ZhangJiebin .1997[1624]. Leijing . Beijing:Zhonghuozhongyiyao.
ZhangDengbenandWu Changchun ,ed.1990.NeijingCidian
ZhangYoujun ,LiWeiandZhengMin .1995.HanYingzhongyi
cihai .Shanxi:ShanxiRenmin.
Zhang Zhicong . 2002[1670].Huangdineijingsuwenjizhu
.Beijing: Xueyuan.
Zhong Yiyuan and Ling Xiang . 1995. Guoxian yi faxian de zuigu
yifangwushierbingfang. Wenwu 9:4960.
Index
acumoxa points, 31, 42,50, 65, 110
13,117,124,127, 154, 161
acupuncture, 3031, 33, 38, 5861,
6366,81,117,123,145,161,178
Akahori,Akira,36
alcohol, 13,41,53, 56, 68, 7980, 95,
101,106,15664,168,176,180
AnLushan,31,90
ancestors,2,11,12829
ancestral tendon, 80, 10708, 112,
119,12834,138,185,190
aphrodisiacs, 17576
BaiShi,26
BanGu,8,33
Baopuzi,4647
bedchamber:arts,2,5,89,11,3738,
44,4648,57,73,80,83,147,151,
165,173,17680;entering,2425,
56,76,86,95,101,106,108,130,
146,151,159,167
Bencaogangmu,175
BianQue,26
bisexuality,1112
blood: and disease, 43, 80, 86, 89,
119, 127, 132,142, 154, 16162;
dryness of, 64, 145, 162, 175;
letting, 59, 66; in women, 96,
102, 141, 14446, 148; see also
menstruation
Bodde,Derk,166
breasts,25,12324,129,143
BronzeAge,15
calendar,140
Campany,Robert,46
CaoChuan,160
Chan,Alan,101,104
ChenHsiufen,56
Chuci,3,7
Chunyu Yi, 26, 28, 53, 56, 86, 124,

165,16062
Cijinlun,161
Confucianism, 2, 9, 11, 47, 83, 127,
150,166
Confucius,20,158,173
cosmology,2,32,39,4144,49,9394,
99,10305,13536,141,
Creel,Herlee,44
Dalefu,10
Daliaofang,160,171,175
DanJi,168
Dao: concept of, 44, 70, 9495, 104;
of sex, 4546, 57, 83, 155, 165,
173,177;supreme,9,35,3940
Daodejing,44,47,93,104,128
Daoist: practice, 40, 4448, 153;sex
ual rites, 75; texts 7, 26, 154;
thought25, 33,51,93
Daoyuan,135
Datongshu,3
Daxue,93
Dayao,59
demons, 5860, 66, 98, 102, 178; ex
orcismof,28,45,5759,66
Despeux,Catherine,32,35,140
Dianculture,1517
Dobson,W.,81
Dongxuanzi,3,70
DouWan,12
dreams,82,86,106,160,162,171
Dreger,Alice,1,142
DuYu,55
DuanYishan,35
Eberhard,Wolfram,166
emotions, 2, 32, 4243, 5356, 6970,
81, 104, 106, 109, 149, 159, 169,
178
211
212 / Index
essence, 25, 45, 53, 58, 6566, 6869,
72,7778,8688,90,96102,107
08, 110, 12526, 129, 138, 141,
154,155,169,175,184
ethics, see Confucianism
eunuchs,14,114,132,17374
family, see Confucianism
FanRui,47
FanZhun,47
FangYizhu,28
fangshi, see skillmasters
Fengsutongyi,136
fertility, 16, 19, 25, 72, 108, 13738,
14149,156,179
Fishlen,Michael,158
fivephases,26,33,4243,55,68,94,
109,14041,143,167,172
flaccidity:54,131;tendon,56,65,80,
82, 112,130, 167;yin, 8485, 95,
117,121,155,17275
food:38,4142,49,54,61,81,8384,
89, 101, 106, 109, 144, 157; and
sex,6768,72,76,163,180
Franke,Herbert,4
Franzblau,A.andE.,13
FuXi,136
FungYulan,139
Furth,Charlotte,32,141
GaoBaoheng,3435
GaoMeibricks,1920
GaoShishi,81,117,141
GeHong,4647,
GoldenAge,6
Goldin,Paul.,163
Graham,A.C.,44,103
graves, see sex,andarchaeology
gu,16568
Guangya,128
Guanzi,93,97
GuoAichun,69
GuoAichun,69,8488,90,118,119,
124,128,130,141,169
Handynasty, passim
Hanemperors,11,30
Hanshu,78,11,2627,28,46,73,80,
167,172
Hanson,Marta,6,27,32
Harper, Donald, 56, 12, 31, 44, 50,
5860,76,81,129,175,183
Heyinyang,56,49,50,71,7577,84,
102,123,131,
HeZhiguo,50
health: care, 4, 31, 33,3943, 45, 49,
52, 63, 95, 108, 137; enhancing,
2,37,47,66,73,78,118,153,155,
160; hazards, 5257, 8384, 87,
101,126,149,156,161,164;and
sex,6,21,2324,38,69,16576
heaven:41,68,72,132,139,173;and
earth, 45, 64, 72, 75, 9296, 98,
10405, 13940, 177; given
years,3739, 41, 49, 55,69, 100,
179,185
heavenly stock, 10001, 135, 13744,
180,181;andhormones,14243
Hinsch,Bret,11
homosexuality,34,11
HouHanshu,47
Hsu,Elisabeth,6,24,26,32,162
HuaTuo,51
Huainanzi,98,104
Huangdi,see YellowEmperor
HuangfuMi,28
immortality,8,26,33,38,41,45,48,
102,179
Ishinp,3,10,71,74,78,83,153,155
JadeInscription,153
Jiayijing,28,112,130
Jinguiyaolue,86
Jiuquan,27,34
KangYouwei,23
Karlgren,Bernhard,94,128
Keegan,David,23,28,30,36
Kessler,Suzanne,1,142
Index / 213
Kleinman,Arthur,55
Kohn,Livia,44
Kokonyjroku,51
Larre,Claude,141
LeiGong,29,30,59
LiCang,5
LiLing,31
LiZhuguo,30
Li,Ling,31,97
Lienzhuan,7,68,168
Liezi,38,44
Liji,7,6869,72,93, 158
Lingshu,21,23,2629,32,37,52,54,
58, 6061, 65, 69, 76, 80, 8285,
99, 108, 11012, 11415, 12122,
131, 148, 162, 16870, 177, 185
90
LiuSheng,1213
LiuXiang,167
LiuXin,32
Lo,Vivienne,31,50,64,174
longevity, 2223, 35, 3751; and
medicine, 64, 73, 104, 150, 177
80;techniques,66,72,138,151
53,177;theory,84,103,169
Lu,GweiDjen,24,65
Lu,Henry,141
Lunheng,142
Lunyu,30,67,69,93,104,167
Lshichunqiu,7,38,69,97
MaJixing,5
MaShi,81,90,11718,120,130,141,
167
Maciocia,Giovanni,32
Maijing,96,149
Maishu,46
MansveltBeck,B.J.
Maspero,Henri,4,44,45
Mawangdui corpus, 47, 1112, 23
26,3132,4344,46,4951,59,61,
65, 68, 7379, 84, 102, 10507,
115, 12127, 144, 151, 164, 170,

172,176,17779
McMahon,Keith,31,97
medicine:anatomy,11534;classical,
23; diagnosis in, 6063; and
drugs,38, 45, 60, 6364, 15960,
167; and healing exercises, 37
38,46,51,57,6566,105,15354;
moxibustion in, 33, 6365, 123;
professionals, 52, 5760; TCM,
22, 2425, 42, 108, 145; theories
in,2223,24;andtreatment,63
66
Mengzi,67,104,163,177
menstruation, 25, 56, 64, 72, 8990,
96,99, 112,114, 12526, 13741,
14247,151
Middendorf,Ulrike,7374,76
Milsky,Constantin,25
Ming dynasty, 4, 911, 13, 58, 81,
164,174
Mingtang,26
moderation,38,41,54,69,95,10001,
164,166,17980
Mozi,93
mulberry,18
mythology,13537
Nanjing,34,96,108,177
Needham,Joseph,4,6,28,140
NewYorkTimes,5
Nguyen,VanNghi,141
NWa,136
Nkejinglun,139
OldYellow,1011
OrchidTower,3
organs:five,29,31,38,4243,53,57,
100, 10708, 109, 115, 129, 131,
138,142,154,172,184;heart,43,
56,61,89,91,104,111,113,122,
12526, 133, 14445, 149, 162,
168; kidney, 25, 4243, 78, 80,
8488,90,96,10001,104,10609,
214 / Index
11213,11719,126,129,13738,
14142, 14546, 149, 162, 169,
172, 181, 18384; sexual, 8283,
85,90,94,10506,110,113,115
23,12528,13033,148,162,171,
17374;spleen, 80, 89,101, 106
07, 119, 121, 130, 144, 163, 167,
173,189;stomach,54,57,8990,
100,113,115,124,163,166
orgasm,66,73,7778,96,10102,123
PanKongshu,63
Peerenboom,R.P.,94
Pengzu,4546
penis: in archaeology, 1216; disor
ders of, 8485, 89, 106, 12021,
133, 154, 55, 17173; in sex, 73
78,82, 113,12123, 15253, 175;
termsfor,115,117,12123
Pfister, Rodo, 6, 13, 75, 81, 97, 99,
122,129,131
physicians (Suwen), 6,2829, 31, 34,
39,49,53,55,57.59,6166,116,
123,147,15961,165,176,178
PlainWoman,3,9,11,45,79,165
poetry,34,711,44,70,74,156,159
Porkert,Manfred,6,97,103
pregnancy, 25, 56, 6264, 96, 126,
142,14750
pulse,33,39,54,6163,65,82,8485,
94, 96, 106, 109, 11011, 124,
14649,154,16162,173,178
qi: 10306; essential, 55, 69, 78, 82,
8788, 99101, 10506, 110, 135,
137, 14142, 149, 160, 169; har
monizing,4,47,75,84,87,137;
methodsof,66,74,78,105,151
56,173,178;procedures,15254
QiBo,2930,33,38,54,58,6065,95,
100, 105, 111, 12526, 13738,
145,149,155,161,162,181
Qidalun,34
Qianjinyaofang,22,51
Qilue,32
Qindynasty,30,171
Qingdynasty,4,11,81,13839
Qipian,10
QuanYuanqi,32,3435,39,149
Renxue,3
rituals,7,48,65,125,15758
Robinson,Douglas,25
RochatdelaValle,Elisabeth,3233
Rongcheng,8
Ryden,Edmund,92
Sakade,Yoshinobu,24,104
Sanhuangwudijing,136
Sanjianeifangyouzifang,147
Schipper,Kristofer,21,32
Schwartz,Benjamin,103
seasons,19,4042,49,53,72,84,105,
109,140,173,178
sex,inarchaeology,1220;dysfunc
tionof,14,25,49,52,85,96,117,
132, 15556, 161, 17076; illus
trated manuals of, 4, 9, 7071;
and lifestyle, 2, 24, 3334, 41,
5354,84,100,164,168,178,185;
positions, 4, 10, 1920, 7071,
139
shamans,5760,66
Shandong and Hebei medical
scholars,81,84,85,119,12021,
128,14142,146,162
Shang dynasty, 24, 59, 140, 15658,
166,168,173
Shanghanlun,22,27,49
Shanhaijing,7
Shennongbencaojing,159
ShiSiming,31
Shiji,7,11,20,26,32,58,94,16263,
174
Shijing,34,7,158,173
Shiming,111
Shishanyian,164
Index / 215
Shiwen, 56, 8, 46, 49, 52,68, 72, 75
78, 82, 102, 115, 117, 160, 163,
175
Shuangmeiyingancongshu,3
Shujing,93,156
Shun,8
Shuowenjiezi,104,111,128,159
Sichuan,1718,31
SimaQian,7,20,26,45,174
SimaXiangru,20
Sivin, Nathan, 6, 24, 27, 32, 35, 44,
97,103
skillmasters,2829,5758,60
sleep,69,76,79,8586,118,160
SongCi,169
Song dynasty, 21, 27, 47, 140, 144,
150,169
Starling,ErnestH.,142
Suepian,910,7071,139
Suidynasty,4
SunSimiao,22
Sunjing,3,10,45,74,165
Suwen: passim; apperception of, 6;
chapters of, 2829, 3334; char
actersfor,2;compilationof,28
33;contentof,2,22,3132;early
history of, 2528; editions of,
3335; and Huangdiwaijing, 27
28; interlocutors in, 2829; and
Leijing, 88, 120; medical theo
riesin,7,35,45,4851;patholo
gies in, 5356; Project, 22, 32;
andrelatedtexts,25;schoolsin,
2930;socialcontextof,7,2728;
studies of, 22; translations of,
2324; Yangsheng Chapters
in,4044,53,155,177,180
Suwenxunjie, 35
Taichanshu,125,144,160
Taisu,21,26,28,39,88,90,120,130,
147,168,172,177
TakedaTsuan,51
TambanoYasuyori,71
TanSitong,3
Tangdynasty,4,10,11,27,3031,35,
40,47,62,90,137,164
Tangdynasty,4,10, 30
Tangrenwuzhi,35
Tessenow, Hermann, 29, 33, 34, 36,
81
testicles,13,16,25,10607,114,117,
121,23,143
Tianlao,8
Tianxiazhidaotan,5,4950,57,64,68,
71, 7478, 84, 86, 102, 117, 123,
15155,165,172
Tianwen,135
Tianyi,8
Tongshengge,9, 74
Tsai,Henry,174
twists, hidden, 24, 75, 8991, 117,
120,170
Umekawa,Sumiyo,66
Unschuld,Paul,6,23,32,35,66,81,
83,166,172
vagina,73,76,8283,87,97,106,113,
116, 118, 120, 12728, 130, 133,
167,171,175
Van Gulik, Robert, 34, 72, 11516,
141,164
Veith,Ilza,28,141
vessels: 25,11014, 12931, 138, 173;
Conception, 96, 108, 124, 137,
181;Governing,96,120,12728;
Jueyin, 91, 117, 12023, 173;
Penetrating,96,108,125,13132,
137; Shaoyin, 62, 113, 147, 149;
and tendons, 85, 87, 101, 130;
theory, 3031, 40, 42, 5052, 61
62, 6566, 82, 94, 11920, 174,
178;Uterus,56,12526,145,148;
Yangming, 89, 117, 119, 121,
123,12930,144
virtue,9,43,52,60,67,98,168
216 / Index
Wang Bing, 3031, 3436, 3940, 49,
68, 72, 8182, 8690, 107, 114,
12627,13031,139,141,14448,
151,162,167,169,182
WangChong,139,142
WangJi,164
way of the yin, 8, 1011, 4647, 73,
81,83
Weakland,John,163
WebstersDictionary,1,21
Welch,Holmes,45
WenYiduo,3
WenZhi,160
Wile,Douglas,6,51,81,107,129
Wilhelm,Hellmut,98
wind,62,80,83,90,101,10304,124,
145, 148, 160, 16263, 166, 168
69,172
women: development of, 96, 108,
112, 128, 13738, 14143, 179,
18183; as enticers, 13, 6768,
16769; and sex, 77, 78, 84, 91,
9899,116120,131,166,17071,
17576;insociety,23,1315,19,
49, 56, 62, 66, 8283, 102, 127,
157,164,173
WuKun,88,126,130,167
Wu,Nelson,141
Wuchengzi,8
Wushierbingfang,31,58,61,76,107,
122,166,175
Wuyunlinianji,136
Xiadynasty,45
Xiajing, 58,80,167
Xianger,47
XiaoXun,138
XinTangshu,90
Xiyuanjilu,169
Xuannjing,3,66
Xunzi,140
Yamada,Keiji,2223
Yang Shangshan, 88, 90, 107, 120,

126, 13031, 141, 14548, 151,
172,18789
Yang,Shouzeng,32
Yangming (Stomach) Vessel), 90,
112, 119,12324,13031,182
Yangshengfang,49,7578,81,84,107,
11516,16061,17172,17576
yangsheng,2,7,3738,45,101
YangtzeRiver,15
Yao,8
YeDehui,3
Yellow Emperor, 6, 8, 2627, 2931,
38, 45, 48, 54, 5861, 105, 111,
13738,149,161,165,185
Yifangmijue,3
Yijing,7,72,92,93,9899,166,183
Yimen,13
Yinshu,46,76,163
Yinyangshiyimaijiujing,31,106,123
yinyang: as sex, 46, 54, 8384, 117,
120; theory 2, 26, 31, 33, 8384,
9296,135,140,144,172
YuZihan,27
Yufangmijue, 3,66,154
Yunjiqiqian,51
ZhangHeng,910,74
ZhangJi,22,27,34,49
Zhang Jiebin, 8789, 117, 120, 124,
126,12730,14647,149,151
ZhangLu,47
ZhangZhicong,8182,9091,11718,
128,130,141,167,187
ZhangZhongjing,86
Zhangjiashan,16,46, 50
Zhenjing,28
Zhongyong,93,140
Zhou dynasty, 11, 15, 19, 59, 153,
15658,160
Zhoubisuanjing,30,140
Zhouli,157,173
Index / 217
Zhuangzi, 7, 3738, 44, 6768, 9394,
97,104
ZouYan,94
Zubishiyimiajiujing,31,123
Zuozhuan, 7, 55, 76, 93, 16566, 170,
173
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Praise for Sex in the Yellow Emperors Basic Questions

Three Pines Press

12. Sexinthe Suwen

Studying Sex in Chinese Culture / 3

works titled Datong shu (Book of Great Unity) and Renxue

Studying Sex in Chinese Culture / 5

The Mawangdui Manuscripts

Studying Sex in Chinese Culture / 7

Sexual Culture in Early China

See Lo2001,21;He andLo1996;Wile1992,19,23;Harper1998,7790.

Studying Sex in Chinese Culture / 9

Fig. 1b. Jade mountain stands

Psychogenic stimulation as part of sexual culture has continued

Studying Sex in Chinese Culture / 11

Sex and Archaeology

Studying Sex in Chinese Culture / 13

Comparingtheangleof an erectpenis to thatofthedoublephalli,

In addition, various bronze dildos were excavated at the site (see

Studying Sex in Chinese Culture / 15

Just as interesting and intriguing are the beautifully carved phalli

Studying Sex in Chinese Culture / 17

In 1972, archaeologists further unearthed stone drawings of an in

The most sexually explicit objects among recent archaeological

Studying Sex in Chinese Culture / 19

Confucius (551479 BCE), amazingly enough, was the product of

Studying Sex in Chinese Culture / 21

17 See Harbsmaiers translation of the Meirenfu (Poetic Essay on

The Yellow Emperors Text / 23

It is importantto differentiate CCM from TCM. TCMtoday, with its no

The Yellow Emperors Text / 25

The Yellow Emperors Text / 27

The Yellow Emperors Text / 29

Compilation and Title

The Yellow Emperors Text / 31

The Yellow Emperors Text / 33

ElisabethRochatdelaValle putsit differently:

Thesubtitle ofthe first volume of the Suwen Projectdescribes it in

The Wang Bing Edition

The Yellow Emperors Text / 35

It appears that Zhuangzi was mocking those who just practiced

The Longevity Connection / 39

Longevity can only be reached when one stays in good physical

It alsoaddsthatabalancedperson is someone whoisnotsick.A

Chapters on Nourishing Life

The Longevity Connection / 41

The Longevity Connection / 43

Daoistic Practices and Sexual Cultivation

The Longevity Connection / 45

Pengzu is nodoubtthe paragon of longevity, associated with vari

None of thebedchambertitles in the Hanshumention Pengzu as a

The Longevity Connection / 47

For a discussion of the bedchamber arts in relation to Daoism, see Kirk

through visualizations. The riteculminated insexual union and was conducted

The Longevity Connection / 49

The Longevity Connection / 51

Women, too, are cautioned to control their emotions, especially during

Althoughdesiresingeneralandsexual urges arenotincludedinthe

Althoughthe Suwen doesnotmentiondiviners as healersas was

The four kinds of health practitioners thus served alongside each

Observing the complexion might be the most common of diag

Thepractice originated in thesouth and also uses fine needles, es

In the Suwen, se appears in four different meanings. The first is

The commentaries on various passages indicate that entering the