The Flourishing Age of Qihuang: Three Hundred Years of Great Medicine in the Sui and Tang
Cháo Establishes the Theory of Disease Sources, Sīmǐao Sets the Standard of 'Great Physician, Sincere Dedication,' Sū Jìng Issues the World's First National Pharmacopoeia — The Golden Age of Chinese Medicine
“A great physician is marked by dedication and sincerity.」 (「大医精诚。」)
— Tang · Sūn Sīmǐao, Beiji Qianjin Yaofang · The Great Physician’s Dedication and Sincerity (《备急千金要方·大医精诚》)
In 581 CE, Yáng Jiān (杨坚) replaced the Northern Zhōu and the Suí (隋) dynasty arose; in 618 CE, Lǐ Yuān (李渊) raised his army in Cháng’ān and the Táng (唐) arose; in 907 CE, Zhū Wēn (朱温) usurped the Táng and the Liáng (梁) arose.
A full three hundred and twenty-six years — China traversed the most glorious stretch of her road — the Kāihuǎng Zhì, Zhēnguān Zhì, and Kāiyuán Shèngshì reigns … the Grand Canal, the imperial examination system, Xuánzàng’s westward journey, Lǐ Bái and Dù Fǔ …
And in medicine, this stretch was equally magnificent —
- Cháo Yuánfāng (巢元方), Zhubing Yuanhou Lun (《诸病源候论》), 50 scrolls — established disease-source studies;
- Sūn Sīmǐao (孙思邈), Qianjin Fang (《千金方》), 60 scrolls — established the standard of the great physician’s dedication and sincerity;
- Sū Jìng (苏敬) and others, Xinxiu Bencao (《新修本草》), 54 scrolls — established the world’s first national pharmacopoeia;
- Wáng Tāo (王焘), Waitai Miyao (《外台秘要》), 40 scrolls — gathered the cumulative achievement of all earlier formularies;
- The Táng Imperial Medical Academy (太医署) in 624 — established the world’s earliest state medical education;
- Jiànzhēn (鉴真)’s six eastward voyages — transmitted medicine to Japan …
Six great pillars, holding up the “Glorious Tang” of Chinese medicine.
At Qihuang Library, today we shall take you back to that age of “ten thousand kingdoms coming to court”, and show how the “Flourishing Age of Qihuang” was forged.
I. Historical Background: Why Did the Glorious Tang Bring Forth Great Physicians?
“To make the ruler a Yáo or a Shùn — how hard can that be?」 (「致君尧舜，此事何难。」)
— Northern Song · Huáng Tíngjiān (黄庭坚), On the Shrine of Lǐ the Exiled Immortal (《题李谪仙祠》)
1. Three Major Background Factors
🏛 National Unification
The Suí ended nearly three hundred years of division — within the short span of 581–589 CE (just 8 years), Emperor Wén of Suí (隋文帝) conquered Chén, and north and south were united; the medicines of the Central Plains and Jiāngnán, of north and south at last flowed together.
The Táng inherited Suí’s institutions, its territory was vast, and Xīyù, the northern deserts, Lǐngnán, and Diānqiān were all part of the realm — the medicines of many peoples and many regions converged.
📜 Comprehensive Institutions
- The imperial examination (kējǔ) system selected officials, and education and culture flourished;
- The Three Departments and Six Ministries (三省六部) brought state governance into a system;
- Laws were strict and detailed; medical-legal provisions were thorough — the Tang Lü Shuyi (《唐律疏议》) stipulated: “Whenever a physician prepares a medicine for a person … if it departs from the original formula and causes injury or death, the offender shall be sentenced to two and a half years of penal servitude.”
🌏 Open Exchange
- The Silk Road ran unobstructed, and “Hu” (foreign) drugs and physicians poured into China in great numbers;
- Japanese envoys to the Tang (qiántángshǐ 遣唐使) and foreign students came in a steady stream, with Korea, Japan, and Annan (Vietnam) all learning medicine from China;
- Jiànzhēn went east, Xuánzàng went west, and Sino-foreign medical exchange flowed in both directions.
Source: Dèng Tiětāo, ed., General History of Chinese Medicine · Ancient Volume, People’s Medical Publishing House, 2000, Chapter 4, “Sui and Tang Medicine”; Tang Lü Shuyi (《唐律疏议》), Scroll 26, article on “Preparing medicine contrary to the formula.”
2. A Snapshot: What Did Those 326 Years Leave Behind?
| Discipline | Representative Work | Author | Nature |
|---|---|---|---|
| Disease-Source Studies | Zhubing Yuanhou Lun (《诸病源候论》), 50 scrolls | Cháo Yuánfāng | Earliest extant monograph on disease sources and manifestations |
| Formularies | Beiji Qianjin Yaofang (《备急千金要方》), 30 scrolls | Sūn Sīmǐao | Clinical encyclopedia |
| Formularies | Qianjin Yifang (《千金翼方》), 30 scrolls | Sūn Sīmǐao | The “wing” to the Qianjin |
| Formularies | Waitai Miyao (《外台秘要》), 40 scrolls | Wáng Tāo | Cumulative achievement of all earlier formularies |
| Materia Medica | Xinxiu Bencao (《新修本草》), 54 scrolls | Sū Jìng and others | World’s first national pharmacopoeia |
| Inner Canon Studies | Huangdi Neijing Taisu (《黄帝内经太素》), 30 scrolls | Yáng Shàngshàn | Earliest classified commentary on the Neijing |
| Inner Canon Studies | Chong Guang Bu Zhu Suwen (《重广补注素问》), 24 scrolls | Wáng Bīng | The most authoritative commentary on the Suwen |
| Obstetrics | Jingxiao Chanbao (《经效产宝》), 3 scrolls | Zǎn Yīn | Earliest extant monograph on obstetrics |
| Traumatology | Xianshou Lishang Xuduan Mifang (《仙授理伤续断秘方》), 2 scrolls | Lìn Dàorén | Earliest extant monograph on traumatology |
| Steaming-Bone Disease | Guzheng Bing Jiufang (《骨蒸病灸方》), 1 scroll | Cuī Zhītì | Specialized monograph on tuberculosis |
| Medical Ethics | The Great Physician’s Dedication and Sincerity (《大医精诚》) | Sūn Sīmǐao | The ethical standard of a millennium |
| Education | Imperial Medical Academy (太医署, 624) | The Court | World’s first state medical school |
| International | Jiànzhēn’s eastward voyage (754) | Jiànzhēn | Chinese medicine officially entered Japan |
Thirteen “firsts”, each of them sufficient to support an entire new age — this is the “Flourishing Age of Qihuang.”
II. Cháo Yuánfāng and the Zhubing Yuanhou Lun: The Founding of Chinese Disease-Source Studies
“The causes of the thousand patterns, the secrets of a thousand years; observe them in the form, seek them in the root.」
1. The Man
Cháo Yuánfāng (巢元方), a person of the 6th–7th centuries CE, Grand Medical Erudite (太医博士) of the Suí, his biographical details remain unclear. In 610 CE (the 6th year of the Dàyè reign), Emperor Yáng of Suí (隋炀帝 Yáng Guǎng) issued an edict to compile medical books, with Cháo Yuánfāng presiding, gathering dozens of imperial physicians, and over several years the Zhubing Yuanhou Lun (《诸病源候论》) was completed.
2. Structure: 50 Scrolls, 67 Categories, 1,739 Manifestations
The Zhubing Yuanhou Lun (《诸病源候论》), 50 scrolls, divided into 67 categories, recording 1,739 patterns and manifestations — each “manifestation (候)” is described in detail as to cause, mechanism, and pathology, but no formulas are listed, making it the first systematic monograph of “disease-source studies (bingyuanxue)” and “manifestation-pattern studies (zhenghouxue)” in Chinese medicine.
📊 Structural Overview
| Categories | Approximate Content | Number of Manifestations |
|---|---|---|
| Scrolls 1–15 | Various winds, deficiency-taxation, cold-damage, seasonal qi, heat diseases | c. 300+ |
| Scrolls 16–30 | Visceral diseases, heart, lung, liver, spleen, kidney disorders | c. 600+ |
| Scrolls 31–40 | External medicine, dermatology, anal-intestinal, ulcers and sores | c. 300+ |
| Scrolls 41–50 | Gynecology, pediatrics, eye/ear/mouth/nose | c. 500+ |
The fact that “no formulas are listed” is the book’s greatest feature — later generations produced many combined editions of “disease source + formula book” — the Song Taiping Shenghui Fang (《太平圣惠方》) would, for each category, first cite passages from the Bingyuan, then list formulas.
3. Five World-Firsts
First, establishing the “disease source – manifestation” pattern-differentiation framework — the thinking paradigm through which later generations of physicians would investigate cause and mechanism of disease, was fixed from this point on.
Second, detailed description of infectious diseases:
- “Pestilential qi (乖戾之气)” — “This disease arises because the seasons are out of harmony, the warm and the cool are out of order, and people are infected by a pestilential qi … the disease qi passes from person to person, even destroying whole households, and extending to those outside.」** (Scroll 10, “Manifestations of Warm Diseases”) — this is one of the earliest concepts of “infectious disease” in the history of world medicine.
- “Gǔ poison (蛊毒)”, “sand mites (沙虱)”, “shègōng (射工)”, “water poison (水毒)” (schistosomiasis, tsutsugamushi disease, etc.) — detailed descriptions of many infectious diseases.
Third, detailed description of allergic diseases:
- “Lacquer sores (漆疮)” (lacquer allergy) — “Whether man or woman, young or old, there are those whose constitution cannot tolerate lacquer; upon seeing lacquer or new lacquerware, they are immediately afflicted by the lacquer poison … but there are also those whose constitution naturally tolerates it, who may boil and heat lacquer all day long and yet suffer no harm.」** (Scroll 35, “Manifestations of Lacquer Sores”) — this is the earliest concept of “allergic constitution” in the history of world medicine.
Fourth, detailed description of surgical operations:
- “Metal wounds” and “severed intestines” — “In cases of severed intestine from a metal wound, one must observe how deep the injury is … if the intestine has been cut through … suture it with fine threads of mulberry bark …」** (Scroll 36, “Manifestations of Severed Intestine from a Metal Wound”) — this is the earliest record of intestinal anastomosis in Chinese external medicine.
Fifth, detailed discussion of obstetrics, gynecology, and pediatrics:
- Hundreds of manifestations of gestational diseases, postpartum diseases, menstrual diseases, and miscellaneous pediatric diseases — the ancestor of later gynecology and pediatrics.
4. A One-Line Summary of Cháo Yuánfāng
“The Bingyuan lists no formulas, but treats only of disease sources; it established the causes of a thousand diseases and opened the eyes of ten thousand physicians — that was the merit of Master Cháo.”
Source: People’s Medical Publishing House, Collated and Annotated Zhubing Yuanhou Lun (《诸病源候论校释》), 1994; [Japanese] Tanba Mototane (丹波元简), Preface to the Zhubing Yuanhou Lun, in Yùshūtáng Medical Selections (《聿修堂医书选》); [Japanese] Yamada Gyōkō (山田业广), Index to the Zhubing Yuanhou Lun, Iseiji Medical Sage Society, Japan, 1916.
III. Sūn Sīmǐao: Medicine King, Great Physician’s Sincere Dedication, and Clinical Encyclopedia
“Human life is of supreme importance; more precious than a thousand pieces of gold; to save a person with one prescription is a virtue beyond this.」 (「人命至重，有贵千金；一方济之，德逾于此。」)
— Tang · Sūn Sīmǐao, Preface to the Beiji Qianjin Yaofang (《备急千金要方·序》)
1. The Man: The Hundred-Year-Old Medicine King
Sūn Sīmǐao (孙思邈), lived c. 581–682 CE (some say 541–682), a native of Jīngzhào Huáyuán (京兆华原) (present-day Yàozhōu Qū, Tóngchuān, Shǎnxī), the greatest physician of the Táng, venerated by later generations as the “Medicine King (药王)”.
His lifespan is still a matter of scholarly debate — the Old Book of Tang and New Book of Tang record that he “lived more than a hundred years” and “died in the first year of the Yǒngchún era”; modern scholarship mostly takes the dates as c. 581–682 CE, giving him a lifespan of 101 years (some say 141 years).
According to the Old Book of Tang · Biography of Sūn Sīmǐao (《旧唐书·孙思邈传》):
- In childhood he “already read Zhuāngzǐ and Lǎozǐ well in his youth”;
- In the Suí he “withdrew to Mount Tàibái, since the royal house was beset by troubles”;
- During the reign of Emperor Tàizōng, when summoned to the capital, “the emperor marveled at how young he looked” — and addressed him as “a man of the Way”;
- During the reign of Emperor Gāozōng, he was offered the post of Counselor-Remonstrant (谏议大夫), but firmly declined it.
“I have heard that one who speaks well of Heaven must verify it in man; one who speaks well of antiquity must accord it with the present; one who speaks well of others must be content with oneself.」 (「吾闻之，善言天者，必有验于人；善言古者，必有合于今；善言人者，必有厌于己。」)
— Suwen · Ju Tong Lun (《素问·举痛论》) (cited by Sīmǐao at the opening of his “On the Study of the Great Physician”)
2. The Qianjin Fang in Sixty Scrolls: A Clinical Encyclopedia
Sūn Sīmǐao’s two great works:
- Beiji Qianjin Yaofang (《备急千金要方》), 30 scrolls, composed c. 652 CE;
- Qianjin Yifang (《千金翼方》), 30 scrolls, composed c. 682 CE.
The two characters “Qianjin (千金, thousand gold)”, taken from the phrase “human life is of supreme importance, more precious than a thousand pieces of gold” — using a thousand gold to figure the preciousness of human life.
📊 Layout and Scale
| Item | Qianjin Yaofang | Qianjin Yifang |
|---|---|---|
| Number of scrolls | 30 scrolls | 30 scrolls |
| Number of categories | 232 categories | 189 categories |
| Number of formulas | c. 5,300 | c. 2,900 |
| Number of medicinals | c. 800 | c. 1,100 |
| Total | 8,200+ formulas, 1,900+ medicinals |
The two works together: 60 scrolls, 8,200+ formulas — a “clinical encyclopedia” without precedent in antiquity.
📊 Subject Classification
The Qianjin Yaofang divides diseases into 232 categories, arranged in the order of gynecology, pediatrics, the five sense organs, internal medicine, external medicine, bone-setting, dermatology, yangsheng, emergency care, acupuncture, incantation-prohibition — this is the earliest model of clinical specialty division in Chinese medicine.
3. “The Great Physician’s Sincere Dedication”: The Ethical Standard of a Millennium
The first scroll of the Qianjin Yaofang contains two chapters: “On the Study of the Great Physician (大医习业)” and “On the Great Physician’s Sincere Dedication (大医精诚)”, devoted to the physician’s virtue, learning, demeanor, and precepts — the highest model of Chinese medical ethics, revered by later generations as “the Eastern Hippocratic Oath”.
📜 Essence of the Original Text
“Whenever a great physician treats disease, he must quiet the spirit and fix the will, without desire or demand; he must first give rise to a great compassionate heart and a heart of怜悯 (sorrow and pity), vowing to save the suffering of all sentient beings. If someone comes to him suffering from illness, he must not ask whether they be noble or base, rich or poor, old or young, beautiful or ugly, enemy or relative, Chinese or foreigner, fool or sage — he must treat all alike as though they were his own closest kin. He must not look back to the past or worry about the future, considering only his own fortune or misfortune, sparing his own life. He must regard the patient’s suffering as his own, deeply grieved in his heart; he must not avoid danger, hardship, day or night, cold or heat, hunger or thirst, fatigue — he must go to the rescue with a single heart, without thought of effort or display. Only thus can he be a great physician for the people; all else is a great thief of sentient beings.」」
— Tang · Sūn Sīmǐao, Beiji Qianjin Yaofang · The Great Physician’s Sincere Dedication (《备急千金要方·大医精诚》)
“Jīng (精)” — mastery of medical skill; “Chéng (诚)” — utter sincerity of medical virtue.
This chapter, though composed several centuries after the founding work of world medical ethics, the Hippocratic Oath, is in fact more systematic in its argument and more refined in its expression — and remains to this day the standard text of the oath taken by Chinese medical students at their entrance into the profession.
4. Clinical Contributions: Ten World-Firsts
First, catheterization of the bladder with a scallion stalk:
“Whenever the urine is not in the bladder, it is because the bladder has become bent and twisted, and the fluids cannot pass. Take a scallion stalk, cut off its tip, insert it into the urethral opening to a depth of three inches, and gently blow into it with the mouth; the bladder will distend, and the fluids will pass freely, and the illness will be cured.」」 (「凡尿不在胞中，为胞屈僻，津液不通，以葱叶除尖头，纳阴茎孔中，深三寸，微用口吹之，胞胀，津液大通便愈。」)
— Qianjin Yaofang · Scroll 20 · Treatise on the Bladder (《千金要方·卷二十·胞囊论》)
This is the earliest record of urinary catheterization in the history of world medicine, 1,200 years earlier than the procedure performed by the French physician Nélaton (1812).
Second, animal thyroid for goiter:
“For goiter: take the thyroid of a deer (lù yè 鹿靥), soak it in wine, broil it dry, place it back in the wine …」」 (「治瘿：取鹿靥（yè）以酒渍，炙干，纳酒中……」)
— Qianjin Yaofang · Scroll 24 · Goiter and Tumor (《千金要方·卷二十四·瘿瘤》)
“Yǐng (瘿)” is goiter, or enlargement of the thyroid — the use of animal thyroid to treat it is the most concrete embodiment of the doctrine of “treating organ with organ (以脏补脏)”.
Third, diagnosis of diabetes:
“Those with xiāo kě (wasting-thirst) … must certainly be people who eat much sweet and fatty food … the urine becomes sweet …」」 (「消渴之人……其人必数食甘美而多肥也……小便至甜……」)
— Qianjin Yaofang · Scroll 21 · Wasting-Thirst (《千金要方·卷二十一·消渴》)
This is the earliest record in the history of world medicine of the “sweet urine” of diabetes, 1,000 years earlier than the Englishman Thomas Willis (1674).
Fourth, gynecology and pediatrics: The Qianjin Yaofang places first, before all other clinical categories, the sections on “women (妇人)” and “infants and young children (少小婴孺)” — the clinical order of “women and children first, then adult men and the aged”, a tradition continued to this day.
Fifth, equal emphasis on acupuncture and drugs: Sīmǐao was master of both the acupuncture and the drug-based systems, and stressed:
“Decoctions attack from within; acupuncture attacks from without; then disease has nowhere to flee.」
Sixth, “Ā-shì points” (阿是穴):
“In Wú and Shǔ, moxibustion is widely practiced, and there is the method of the ‘Ā-shì point.’ This means that when a person has pain, one pinches the area; where one feels it is the right place, regardless of whether it is a recognized acupuncture point — the place that gives relief or soreness on pressure is called ‘Ā-shì.’ Moxibustion and needling at this point are both effective, and that is why it is called the Ā-shì point.」」 (「吴蜀多行灸法，有阿是穴之法，言人有病痛，即令捏其上，若里当其处，不问孔穴，即得便快成（痛）处，即云阿是，灸刺皆验，故曰阿是穴也。」)
— Qianjin Yaofang · Scroll 29 · Examples of Moxibustion (《千金要方·卷二十九·灸例》)
“Ā-shì points” — taking the sore spot as the acupoint — still widely used in modern acupuncture clinic.
Seventh, the “Thirteen Ghost Points” (十三鬼穴) (Thirteen Needles of the Ghost Gate): Sūn Sīmǐao compiled and arranged “Bian Que’s Thirteen Ghost Points”, for the treatment of “mania and psychosis” and other mental disorders — an early exemplar of the principle of “treating mind and body together.”
Eighth, formulas still in clinical use: Wēn Pí Tāng (温脾汤, Warm-the-Spleen Decoction), Xī Jiǎo Dì Huáng Tāng (犀角地黄汤, Rhinoceros Horn and Rehmannia Decoction), Dú Huó Jì Shēng Tāng (独活寄生汤, Pubescent Angelica and Mistletoe Decoction) and other renowned formulas — still today part of the common formulary of Chinese clinical medicine.
Ninth, “Foods Suitable for the Five Zang” and dietary therapy: Sūn Sīmǐao set apart a whole chapter on “Food Therapy (食治)” in the Qianjin Yaofang, the first systematic discussion of channel-entry of foods and the unity of medicine and food — the ancestor of later Mèng Shēn’s (孟诜) Shiliao Bencao (《食疗本草》).
Tenth, the integration of the Indian “Four Greats” into Chinese medicine: In the opening chapter of the Qianjin Yaofang (Scroll 1), Sīmǐao cited the Indian “Four Greats (四大, earth-water-fire-wind)” doctrine:
“Earth, water, fire, and wind combine to form the human being …」
This is the earliest written record of Chinese medicine’s absorption of Indian medicine — a medical witness to the openness of the glorious Tang.
Source: Old Book of Tang · Biography of Sūn Sīmǐao (《旧唐书·孙思邈传》), compiled by Later Jìn · Liú Xù (刘昫); New Book of Tang · Biography of Sūn Sīmǐao (《新唐书·孙思邈传》), compiled by Song · Ōuyáng Xiū (欧阳修); Lǐ Jīngwěi and Lín Zhāogēng, eds., General History of Chinese Medicine · Ancient Volume, Chapter 4; [Japanese] Miyashita Saburō (宫下三郎), Research on Sūn Sīmǐao, Institute for Research in the Humanities, Kyoto University, 1962.
5. A One-Line Summary of Sūn Sīmǐao
“Master of his art, sincere in his heart; he wrote the Qianjin and transmitted medical virtue; teacher of a hundred generations, opener of ten thousand ages of learning.」
IV. Wáng Tāo and the Waitai Miyao: The Cumulative Achievement of All Earlier Formularies
“‘Waitai’」 means ‘the Waitai of the Zhongshu Sheng.’」」
— Tang · Wáng Tāo, Preface to the Waitai Miyao (《外台秘要·自序》)
1. The Man: Grandson of a Prime Minister, Archivist of the Hongwen Pavilion
Wáng Tāo (王焘, c. 670–755), a native of Wànnián, Shǎnxī (万年, 陕西) (present-day Xī’ān), a great-grandson of the Táng prime minister Wáng Guī (王珪), a younger cousin of the Right Vice-Director of the Department of State Affairs Wáng Hóng (王鉷), “seven times admitted to the Southern Palace, twice honored at the Eastern Gate, busied in the archives for more than twenty years”, he served for many years in the Hongwen Pavilion (弘文馆) and the Department of State Affairs (尚书省), and had the opportunity to read the great quantity of medical books in the imperial collection.
2. The Waitai Miyao in 40 Scrolls: The Cumulative Achievement of Earlier Formularies
The Waitai Miyao (《外台秘要》), 40 scrolls, completed in 752 CE, records more than 6,000 formulas and more than 1,100 medicinals, divided into 1,104 categories, citing “more than sixty” earlier medical authors — Zhāng Zhòngjǐng, Wáng Shūhé, Huángfǔ Mì, Gě Hóng, Fàn Wāng, Chén Yánzhī, Yáo Sēngyuán, Shēn Shī, Cuī Zhītì, Zhāng Wénzhōng, and others are all quoted.
The meaning of “Waitai (外台)”: Among the three departments of the Táng — Shàngshū Shěng (尚书省, Department of State Affairs), Zhōngshū Shěng (中书省, Secretariat), and Ménxià Shěng (门下省, Chancellery) — the Shàngshū Shěng was also called “Zhōngtái (中台, Central Terrace)”, the Ménxià Shěng was called “Dōngtái (东台, Eastern Terrace)”, and the Zhōngshū Shěng was called “Xītái (西台, Western Terrace)”; Wáng Tāo had served as a directorate official (郎官) and a wàiláng (外郎, vice-official) of the Shàngshū Shěng, so “Waitai” is an alternative name for the “Shàngshū láng (尚书郎, gentlemen of the Department of State Affairs)” — this book is the “secret essentials” (秘要) of medicine gathered by Waitai (a Shàngshū láng) Wáng Tāo.
📊 Subject Structure
| Scrolls | Categories |
|---|---|
| 1–6 | Cold-damage, epidemic fevers, warm diseases |
| 7–20 | Internal miscellaneous diseases |
| 21–30 | External medicine, dermatology, five sense organs |
| 31–36 | Gynecology, pediatrics |
| 37–38 | Moxibustion, needling |
| 39–40 | Taking elixirs, cultivation of nature, incantation-prohibition |
3. Three Major Contributions
First, preserving lost formularies: Wáng Tāo quoted extensively from already scattered and lost works such as the Xiaopin Fang, Fan Wang Fang, Jiyan Fang, Shenshi Fang, Gujin Luyan, and others — without the Waitai, these Jìn and Táng formularies could not be traced by later generations.
Second, equal emphasis on formulas and patterns, with clear arrangement: For each category, he first discussed the disease source (often citing Cháo Yuánfāng), then listed the formulas and medicinals (noting the source of each), and this “disease source + formula” one-stop paradigm was imitated by all later large-scale formularies.
Third, transmission to Japan, popularity abroad: In Japan’s Heian period (9th–12th centuries CE), the Waitai Miyao entered Japan, and was enrolled as a medical textbook; in the Edo period, Kajiwara Shōzen’s (梶原性全) Wanan Hō (《万安方》) quoted it extensively.
Source: New Book of Tang · Treatise on Literature and Arts (《新唐书·艺文志》), medical section; [Japanese] Kosoto Hiroshi (小曾户洋), Documentary Studies on the Waitai Miyao, in Tōyō Igaku Zenpon Sōsho, Vol. 8, Tōyō Igaku Kenkyūkai, 1981.
4. A One-Line Summary of Wáng Tāo
“He created no formula, advanced no theory, but with the strength of one man gathered the formulas of a hundred generations; without the Waitai, the formularies of the Jìn and Táng would largely have been lost — this is the merit of Wáng Tāo.」
V. Sū Jìng and the Xinxiu Bencao: The World’s First National Pharmacopoeia
“The state has its eternal standards; the people have their eternal cures.」
1. Background to the Compilation
The Táng inherited the Suí, and materia medica had followed Táo Hóngjǐng’s Bencao Jing Jizhu for more than a hundred years — because of “the times had changed and the things differed”, and “errors had been inherited and mistakes compounded”, the materia medica urgently needed to be reorganized and revised.
In 657 CE (the 2nd year of the Xiǎnqìng reign of Emperor Gāozōng of Táng), Sū Jìng (苏敬), the Senior Director of the Right Guard Gate Office (右监门府长史) (some accounts say Sū Jìng was the “verifier” (检校) of the actual compilation), memorialized the throne:
“The Bencao Jing Jizhu annotated by Táo Hóngjǐng … its judgments are not always correct … I pray that the subject be assigned to this minister for compilation, that it be carefully corrected, and that the errors be excised.」
Emperor Gāozōng decreed Sū Jìng and twenty-two others to revise the materia medica in detail; after two years of work, in 659 CE (the 4th year of Xiǎnqìng) the work was completed in 54 scrolls, and promulgated by the court —
this is the Xinxiu Bencao (《新修本草》), also known as the Tang Bencao (《唐本草》).
2. Structure and Scale
| Item | Content |
|---|---|
| Number of scrolls | 54 scrolls (including 1 scroll of contents, 25 scrolls of drug illustrations, 7 scrolls of illustrated explanations) |
| Medicinals recorded | 850 (114 newly added) |
| Classification | Following Táo Hóngjǐng’s “minerals, plants, insects-and-beasts, fruits, vegetables, grains-and-foods, famous-but-unused” — nine categories |
| Illustrations | Accompanied by 25 scrolls of drug illustrations (now lost) — the earliest color-illustrated materia medica atlas in China |
| Promulgation | Emperor Gāozōng issued it to the whole realm; in all medical practice it had to be observed |
3. Three Historical Firsts
First, the world’s first national pharmacopoeia: The Xinxiu Bencao (659 CE) predated the earliest European pharmacopoeia, the Nuremberg Pharmacopoeia (1542), by 883 years — scholarly consensus: “China is the homeland of the world’s pharmacopoeias.」
Second, state legislation to protect pharmacology: The Táng Code stipulated:
“Whenever medicines have their noble and base, prescriptions and the medicines in them must be prepared according to the original formula … if one privately alters a formula and thereby causes a death, the offender shall be punished according to the law.」
Materia medica was for the first time regulated by law.
Third, originating the “illustrated explanation” (图经) paradigm: Sū Jìng and his collaborators drew the materia medica illustrations, words and pictures together — directly inherited by the later Bencao Tujing (《本草图经》) of the Song physician Sū Sòng (苏颂).
4. A One-Line Summary of Sū Jìng
“From Sū Jìng onward, the Bencao had a state standard; Chinese pharmacognosy thus moved from ‘private learning’ to ‘official learning.’」
Source: New Book of Tang · Treatise on Literature and Arts (《新唐书·艺文志》); Shàng Zhìjūn, Reconstructed Edition of the Xinxiu Bencao (《新修本草（辑复本）》), Anhui Science and Technology Press, 1981; [Japanese] Ōkanishi Yūjin (冈西为人), Outline of Bencao Studies (《本草概说》), Sōgensha, 1977.
VI. Official Medical Education: The Imperial Medical Academy (太医署) — The World’s First “Medical School”
“The state has its great physicians, who hold the lives of the people in their charge.」
1. Its Establishment
In 624 CE (the 7th year of the Wǔdé reign of Emperor Gāozōng of Táng), inheriting the Suí system, the Imperial Medical Academy (太医署) was formally established, subordinate to the Court of Imperial Sacrifices (太常寺), and was the central government’s highest medical education and medical administration institution — this was the world’s first state medical school.
2. Departments and Curriculum
The Imperial Medical Academy was divided into four departments:
- Medicine (医科) — the largest;
- Acupuncture (针科);
- Massotherapy (按摩科);
- Incantation and Prohibition (咒禁科).
The Medicine Department was further divided into five specialties:
- Body-treatment (体疗, internal medicine) — 7 years of study;
- Ulcer and Swelling (疮肿, external medicine) — 5 years of study;
- Young and Small (少小, pediatrics) — 5 years of study;
- Ears, Eyes, Mouth, Teeth (五官) — 4 years of study;
- Horn-method (角法, external treatment: cupping, moxibustion) — 3 years of study.
3. Teacher-Student Configuration
| Role | Number | Task |
|---|---|---|
| Grand Physician (太医令) | 1 | Administrative chief |
| Assistant Grand Physician (太医丞) | 2 | Deputy |
| Medical Erudite (医博士) | 1 per department | Principal lecturer |
| Assistant Medical Instructor (医助教) | 1–2 per department | Tutor |
| Medical Masters (医师) | 10–20 per department | Clinical instructors |
| Medical Workers (医工) | Several dozen | Assistants, dispensers |
| Students | Several dozen per department | Trainees |
4. Examinations and Advancement
- Monthly, quarterly, and annual examinations on three levels;
- Those of outstanding performance were retained; the inadequate were dismissed;
- After graduation, students were assigned to posts in the regions as Medical Erudite, Medical Masters, or Medical Workers.
This was the world’s first systematized medical education system — nearly three centuries earlier than Europe’s earliest, the Schola Medica Salernitana (Italy, 9th century); six centuries earlier than the Paris medical school (13th century).
Source: Tongdian (《唐六典》), Scroll 14, article on “Imperial Medical Academy”; New Book of Tang · Treatise on the Hundreds of Officials (《新唐书·百官志》), article on “Imperial Medical Academy”; Lǐ Jīngwěi and Lín Zhāogēng, General History of Chinese Medicine · Ancient Volume, Chapter 4.
VII. The Huangdi Neijing Taisu and Wáng Bīng’s Commentary: The Crystallization of Inner Canon Studies
1. Yáng Shàngshàn’s Huangdi Neijing Taisu
Yáng Shàngshàn (杨上善, c. 6th–7th century CE), a person of the Suí (some say Táng), Instructor of the Crown Prince (太子文学) and Tōngzhí Láng (通直郎), authored the earliest classified commentary on the Huangdi Neijing now extant. The book has 30 scrolls (25 surviving), and is the first to use “classification by content” for commentary: he dismantled the original text of the Suwen and Lingshu and rearranged it under 19 major categories — nurturing life, yin–yang, correspondence of man and heaven, viscera, meridians, acupoints, nutritive and defensive qi, body measurements, diagnostic indicators, patterns and manifestations, prescription, nine needles, tonification and reduction, cold-damage, cold and heat, theories of evil, theories of wind, theories of qi, theories of reversal, miscellaneous diseases — the ancestor of all later classified editions of the Neijing.
2. Wáng Bīng’s Chong Guang Bu Zhu Huangdi Neijing Suwen
Wáng Bīng (王冰, c. 710–805), styled Qǐxuánzǐ (启玄子), served as Grand Master of the Imperial Stud (太仆令) in the Bǎoyìng (762) years of the Táng, and over the course of 12 years reorganized the Suwen, producing the Chong Guang Bu Zhu Huangdi Neijing Suwen (《重广补注黄帝内经素问》) in 24 scrolls, 81 chapters.
Contributions: First, he supplemented the “Seven Great Treatises (七篇大论)” — “Treatise on the Heavenly Origin Record (天元纪大论)”, “Treatise on the Fivefold Circuit (五运行大论)”, “Treatise on the Subtle Significance of the Six (六微旨大论)”, “Treatise on the Changes of Qi-Interaction (气交变大论)”, “Treatise on the Fivefold Government (五常政大论)”, “Treatise on the Six-Yuan Normal Records (六元正纪大论)”, “Treatise on the Most True and Essential (至真要大论)” — the theoretical core of the wuyun liuqi (五运六气, five movements and six qi) — the Suwen as it exists today is the 24-scroll edition of Wáng Bīng.
Second, he annotated in full detail — all later study of the Suwen has used Wáng Bīng’s edition as its base text — its status is comparable to that of Zhū Xī’s commentary on the Four Books.
Third, he established the “Seven Treatises on the Movements (运气七篇)” as the core of Chinese chronomedicine — required reading in clinical practice.
Source: Preface to the Chong Guang Bu Zhu Huangdi Neijing Suwen (《重广补注黄帝内经素问·自序》); People’s Medical Publishing House photographic reprint, Huangdi Neijing Suwen, 1956.
VIII. Specialty Monographs: Two Milestones in Obstetrics and Traumatology
1. Zǎn Yīn’s Jingxiao Chanbao: The Earliest Extant Obstetrics Monograph
Zǎn Yīn (昝殷, c. 8th–9th century CE), a person of the late Táng, a famous physician of Shǔ (Sichuan), authored the Jingxiao Chanbao (《经效产宝》) in 3 scrolls (also called Chanbao), completed between 847 and 852 CE — the earliest extant monograph on obstetrics.
Contents:
- 12 formulas for gestational diseases;
- 16 formulas for difficult labor;
- 25 formulas for postpartum diseases;
- Methods for hastening birth, expelling the fetus, and inducing abortion.
Later the Furen Daquan Liangfang (《妇人大全良方》) of the Song physician Chén Zìmíng (陈自明) directly inherited from it.
2. Lìn Dàorén’s Xianshou Lishang Xuduan Mifang: The Earliest Extant Traumatology (Bone-Setting) Monograph
Lìn Dàorén (蔺道人), a monk of the late Táng (9th century), his real name is unknown, a recluse at Mount Xī (西山) in Hóngzhōu (洪州, modern Nánchāng) in Jiāngxī, who transmitted his art to a colleague “by the Way”. His Xianshou Lishang Xuduan Mifang (《仙授理伤续断秘方》) in 2 scrolls, is the earliest extant monograph on traumatology and bone-setting.
Contributions:
- The first systematic ten-step method of bone-setting: anesthesia → debridement → reduction → splinting → oral medication → washing → dressing change → re-examination → rehabilitation → recuperation of the spirit;
- The first “chair-back reduction” for the treatment of shoulder dislocation;
- The first use of cedar splints for fixation — a method still in use today;
- Records of famous trauma formulas such as Táo Hóng Sì Wù Tāng (桃红四物汤, Peach Kernel and Four-Substance Decoction) and Dà Huóxuè Dān (大活血丹, Great Blood-Activation Elixir).
Source: Zhongyi Guji Chubanshe photographic reprint, Jingxiao Chanbao, 1984; People’s Medical Publishing House collated and annotated edition, Xianshou Lishang Xuduan Mifang, 2006; Wéi Yǐzōng, History of Chinese Orthopedic Technology (《中国骨科技术史》), Shanghai Scientific and Technological Literature Publishing House, 2008.
IX. Jiànzhēn’s Eastward Voyage: Chinese Medicine Officially Enters Japan
“This is the work of the Dharma; why should I begrudge my life?」
1. The Man
Jiànzhēn (鉴真, 688–763), a Táng-dynasty monk of great repute in the Lǜzōng (律宗, Vinaya school), a native of Yángzhōu, Jiāngsù, a transmitter of the Nánshān (南山) branch of the Lǜzōng, “peerless and unrivaled, the hearts of clergy and laity alike turned to him”.
2. The Six Eastward Voyages
In 742 CE, the Japanese monks Róng Ruì (荣叡) and Pǔ Zhào (普照), entrusted by Emperor Shōmu (圣武天皇), came to China to invite Jiànzhēn to travel east to transmit the Vinaya, confer the precepts, and additionally transmit medicine and pharmacy. In 754 CE (the 14th year of the Tiānbǎo era of Emperor Xuánzōng of Táng), Jiànzhēn’s sixth eastward voyage at last succeeded, and he arrived in Nara, Japan — after five prior failures (storms, losing his way, drifting to the southern seas, falling ill of the eyes), he had lost the sight of both eyes, at the age of 66.
3. His Contributions to Japanese Medicine
- He transmitted the Tang Bencao to Japan;
- He brought a great quantity of medicines and formulas into Japan;
- He personally taught the identification, processing, and combination of drugs;
- He created a number of “Jiànzhēn formulas”;
- Japan venerated him as the “Medicine King” and “ancestor of medicine and pharmacy”;
- The medicines in his “Shōsōin (正仓院)” repository are still partly preserved to this day.
Source: Man’abu Genkai (真人元开), Record of the Eastern Excursion of the Tang Monastery’s Great Master (《唐大和上东征传》), 779 CE, Wāng Xiàngróng annotated edition, Zhonghua Book Company, 2000; [Japanese] Man’abu Genkai, Annotated Record of the Eastern Excursion of the Tang Monastery’s Great Master, Heibonsha, 1981.
X. Medicine in the Sui and Tang: A Master Table
“Three hundred years of the glorious Tang, the Way of Medicine a garden in full spring.」
| Period | Dynasty | Physician | Representative Work | Contribution |
|---|---|---|---|---|
| 581–618 | Suí | Yáng Shàngshàn | Huangdi Neijing Taisu (《黄帝内经太素》) | Earliest classified commentary on the Neijing |
| 581–618 | Suí | Cháo Yuánfāng | Zhubing Yuanhou Lun (《诸病源候论》) | Earliest disease-source studies; 1,739 manifestations |
| 581–682 | Táng | Sūn Sīmǐao | Qianjin Yaofang and Qianjin Yifang (《千金要方》《千金翼方》) | Clinical encyclopedia; “The Great Physician’s Sincere Dedication” |
| 605–621 | Suí–Táng | Xǔ Yìnzōng | (medical cases recorded) | The doctrine of “medicine lies in the mind” |
| 657–659 | Táng | Sū Jìng and 22 others | Xinxiu Bencao (《新修本草》) | World’s first national pharmacopoeia |
| 670–755 | Táng | Wáng Tāo | Waitai Miyao (《外台秘要》) | Cumulative achievement of earlier formularies |
| 710–805 | Táng | Wáng Bīng | Chong Guang Bu Zhu Suwen (《重广补注素问》) | The most authoritative commentary on the Suwen |
| 8th century | Táng | Zǎn Yīn | Jingxiao Chanbao (《经效产宝》) | Earliest extant obstetrics monograph |
| 8th–9th century | Táng | Cuī Zhītì | Guzheng Bing Jiufang (《骨蒸病灸方》) | Monograph on tuberculosis |
| 8th–9th century | Táng | Zhāng Wénzhōng | Liao Fengqi Zhufang (《疗风气诸方》) | Specialized monograph on wind diseases |
| 9th century | Táng | Lìn Dàorén | Xianshou Lishang Xuduan Mifang (《仙授理伤续断秘方》) | Earliest extant traumatology monograph |
| 688–763 | Táng | Jiànzhēn | (Eastward transmission of medicine) | Chinese medicine officially entered Japan |
| 624 | Táng | Imperial Medical Academy (太医署) | Official school | World’s first state medical school |
Thirteen physicians, thirteen monuments — each of them sufficient to illuminate a thousand years.
XI. Why the Sui and Tang Was the “Age of Great Physicians” in Chinese Medicine
1. From “Disciplines” to “Specialties”
The Wei, Jin, and Northern and Southern Dynasties laid the foundations, the Suí and Táng specialized the disciplines:
- Disease-source studies (Zhubing Yuanhou Lun);
- Materia medica (Xinxiu Bencao);
- Inner Canon studies (Taisu, Wáng Bīng’s commentary);
- Obstetrics (Chanbao);
- Traumatology (Lishang Xuduan Mifang) — Chinese medicine for the first time possessed a clear “specialty division.”
2. From “Private Schooling” to “Official Schooling”
The Imperial Medical Academy (624 CE) brought Chinese medical education for the first time into the state system — this was several centuries earlier than European medical schools.
3. From “Central Land” to “East Asian Medical Sphere”
- Japan — envoys to the Tang, Jiànzhēn’s eastward voyage;
- Korea — the Xīnluó (新罗) kingdom established medical institutes, drawing their learning from the Táng;
- Vietnam — Vietnamese medicine was deeply influenced by Chinese medicine.
Chinese medicine leaped from being “the medicine of the Central Land” to being “the ancestor of all East Asian medicine.”
4. From “Technique” to “Medical Virtue”
Sūn Sīmǐao’s “Great Physician, Sincere Dedication” gave Chinese medicine for the first time a systematic medical ethics — this was Chinese medicine’s spiritual dimension that transcended mere technique.
XII. Echoes in the Modern World
🏛 The Imperial Medical Academy and Today’s Colleges of Chinese Medicine
In 1956, China established four colleges of Chinese medicine: Beijing University of Chinese Medicine, Shanghai University of Chinese Medicine, Guangzhou University of Chinese Medicine, Chengdu University of Chinese Medicine — these are the modern “Imperial Medical Academies”; their teaching system still takes “classics first, clinic second” as its foundation.
🌍 The Xinxiu Bencao and the World’s Pharmacopoeias
The U.S. Pharmacopoeia (USP) of 1898; the 2010 edition of the Pharmacopoeia of the People’s Republic of China for the first time established “Traditional Chinese Medicine” as an independent part — this is the continuation of the “officially compiled pharmacopoeia” tradition of Sū Jìng’s Xinxiu Bencao.
🪷 Jiànzhēn and Sino-Japanese Medical Exchange
In 1980, the seated statue of Jiànzhēn returned to Yángzhōu to “visit home”; in 1992 China built the “Memorial Hall of Jiànzhēn” in Nánjīng; today’s Sino-Japanese medical exchange still proceeds along Jiànzhēn’s path.
📜 Cháo Yuánfāng and Modern Immunology
Allergy, immunity, and infectious disease — the central themes of modern medical research — Cháo Yuánfāng had already observed their important phenomena 1,400 years ago, and this is the foresight of Eastern wisdom.
XIII. Coda: Why the Glorious Tang Became the Age of Great Physicians
“The glory of the glorious Tang lay not in the splendor of Cháng’ān, but in the flourishing of the Way of Qihuang.」
Three Great Reasons
1. National Unification, Open Roads for Medicine
The medicines of north and south flowed together; Central Plains and Western Regions medicines exchanged; state law provided protection; state education offered support — this was the political foundation of the “age of great physicians.”
2. Open Scholarship, Inheriting the Past and Opening the Future
Inheriting the learning of the Wei and Jin; gathering the formulas and medicinals of the Jìn and Táng; opening the way for later schools of thought — Suí–Táng medicine was an age of “great synthesis” and “great new beginnings.”
3. The Medicine King Sets the Ethical Standard, Teacher of Ten Thousand Generations
Sūn Sīmǐao’s “Great Physician, Sincere Dedication” for the first time clearly defined the spiritual height of the physician; this was the soul of Chinese medicine that transcended technique.
🪶 A One-Line Summary
“The three hundred years of Sui and Tang saw the Way of Qihuang at last move from ‘medicine’ to ‘great medicine’ — with learning, with art, with virtue, with teaching, and with transmission; it was the golden age of Chinese medicine, and also the spiritual highland of Chinese medicine.」
XIV. A Word from Qihuang Library
“Before them, the foundation-laying of Wei and Jin;
After them, the hundred-schools contention of Song, Jin, and Yuan;
In the middle, the glorious Tang left us Cháo’s disease sources,
Sīmǐao’s Sincere Dedication, Sū Jìng’s pharmacopoeia, Wáng Tāo’s formularies, and the Imperial Medical Academy’s official schooling — five pillars standing together, the right way of Qihuang.」
Today, when we make clinical pattern identifications — we follow Cháo Yuánfāng’s “disease source – manifestation” framework; when we treat the sick and save lives — we recite from memory Sūn Sīmǐao’s “Great Physician, Sincere Dedication”; when we teach and research materia medica — we study Sū Jìng’s “illustrated-explanation” method; when we organize formulas and medicinals — we trace back to Wáng Tāo’s “formula–pattern” arrangement; when we study in a college of Chinese medicine — we follow the thousand-year-old curriculum of the Imperial Medical Academy.
This is the Sui and Tang — the “age of great physicians” of Chinese medicine.
“Sīmǐao’s Sincere Dedication won the seat of Medicine King;
Master Cháo’s disease sources opened the great treatise;
Sū Jìng’s pharmacopoeia launched official scholarship;
Wáng Tāo’s Waitai gathered the formulas of a hundred ages.」
Qihuang Library, together with you, will continue to walk through the hundred-schools contention of Song, Jin, and Yuan, will continue to walk through the great synthesis and the warm-disease school of Ming and Qing — walking the three-thousand-year road of Chinese medicine to its end.
In our next installment, we shall go to the Northern Song’s Kāifēng (开封), and enter the “Bureau of Medical Revisions (校正医书局)” — to see how Lín Yì (林亿), Sūn Qí (孙奇), Gāo Bǎohéng (高保衡) and other Confucian physicians transformed Chinese medicine into “official learning”; and then to witness the brilliance of the Four Masters of the Jīn and Yuán — Liú Wánsù’s (刘完素) “School of Cold and Cool (寒凉派)”, Zhāng Cóngzhèng’s (张从正) “School of Attacking Evil (攻邪派)”, Lǐ Dōngyuán’s (李东垣) “School of Spleen and Stomach (脾胃派)”, and Zhū Dānxī’s (朱丹溪) “School of Nourishing Yin (滋阴派)” — and how the hundred schools contended.
📜 The Flourishing Age of Qihuang, the Sincere Dedication of the great physician;
The torch passes from hand to hand, life after life, without end.