Essential Subtleties on the Silver Sea: The Yin-Hai Jing-Wei: A Chinese Classic on Opthalmology [Reprint 2020 ed.] 9780520913219

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Essential Subtleties on the Silver Sea

C O M P A R A T I V E S T U D I E S OF HEALTH SYSTEMS AND MEDICAL CARE

General Editor John M. Janzen Founding Editor Charles Leslie Editorial Board Don Bates, M.D., McGill University Frederick L. Dunn, M.D., University of California, San Francisco Kris Heggenhougen, Harvard University Brigitte Jordan, Michigan State University Shirley Lindenbaum, The Graduate School and University Center of the City University of New York Patricia L. Rosenfield, The Carnegie Corporation of New York Paul U. Unschuld, University of Munich Francis Zimmermann, Centre National de la Recherche Scientifique, Paris

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The Chinese Medical Classics

Essential Subtleties on the Silver Sea The Yin-hai jing-wei: A Chinese Classic on Ophthalmology

TRANSLATED AND ANNOTATED BY

Jurgen Kovacs and Paul U. Unschuld

U N I V E R S I T Y OF CALIFORNIA PRESS Berkeley

Los Angeles

London

The publisher gratefully acknowledges the generous contribution toward the publication of this book provided by the Chiang Ching-kuo Foundation for International Scholarly Exchange.

University of California Press Berkeley and Los Angeles, California University of California Press London, England Copyright © 1998 by T h e Regents of the University of California

Library of Congress Cataloging-in-Publication Data Sun, Ssu-miao, 581-682 [Yin hai ching wei. English] Essential subtleties on the silver sea : the Yin-hai jing-wei : a Chinese classic on ophthalmology / translated and annotated by Jürgen Kovacs and Paul U . Unschuld. p. cm. — (Comparative studies of health systems and medical care ; no. 38) Includes bibliographical references and index. At head of title: Chinese medical classics. ISBN 0-520-08058-0 (cloth : alk. paper) 1. E y e — D i s e a s e s — E a r l y works to 1800. 2. Medicine, C h i n e s e — Early works to 1800. I. Kovacs, Jürgen. II. Unschuld, Paul U. (Paul Ulrich), 194.3- . III. Title. IV. Title: Yin-hai jing-wei. V . Title: Chinese medical classics. VI. Series. [ D N L M : 1. Eye Diseases. 2. Medicine, Chinese Traditional. C O 4 3 7 S no. 38 1998 / W Z 290 Sg57yc 1998a] RE48.S8613 1998 617.7—dc2i DNLM/DLC for Library of Congress

Wi

97-138 CIP

Printed in the United States of America 1 2 3 4 5 6 7 8 9 T h e paper used in this publication meets the minimum requirements of American National Standard for Information Sciences—Permanence of Paper for Printed Library Materials, A N S I Z39.48-1984

CONTENTS

Preface

xi

PARTI:

PROLEGOMENA

INTRODUCTION

1.1.

3

The Yin-hai jing-wei

T H E E Y E AND E Y E A F F L I C T I O N S IN HISTORICAL

1.2. 1.3. 1.4. 1.5.

SUI-TANG

1.6. 1.7. 1.8.

CHINA-

RETROSPECTION

Earliest Evidence Zhou, Qin, Early Han Idiosyncrasy of Chinese Medicine The Huang-di neijing and Further Han Sources on Ophthalmology

6 9 17 22

OPHTHALMOLOGY

The %h.u bingyuan The Qian jin fang The Wax tai biyao

hou lun

29 34 37

SONG O P H T H A L M O L O G Y

1.9. 1.10. 1.11.

India in Chinese Ophthalmology The Shengji zong lu Song-Jin-Yuan: The Four Great Reductionists

43 49 50

si

CONTENTS

T H E YIN-HA

1.12. 1.13. 1.14. 1.15. 1.16. 1.17. 1.18. 1.19.

I

JING-WEI

Date and Structure of the Text T h e Anatomy of the Eye O n Disease and Illness: T h e Emic Perspective Images of the Afflicted Eye T h e Treatment: General Principles Pharmaceutics Surgery Clinical Pathology in the Yin-hai jing-wei: T h e Etic Perspective

P A R T II: T H E T E X T O F T H E E D I T O R I A L S AND

II. 1.

II.2. II. 3.

11.4. 11.5. 11.6. 11.7. 11.8. 11.9. 11.10. 11.11. 11.12. 11.13. 11.14. 11.15. 11.16. 11.17.

YIN-HAIJING-WEI

PREFACES

Editorial to the %uigeng tang Edition, Ming. Preface to the Block-printed Edition of the Essential Subtleties on the Silver Sea Editorial to the Si ku quan shu Edition of 1781 Preface to the Essential Subtleties on the Silver Sea

INTRODUCTORY

53 58 65 71 75 77 81 86

119 121 124

MATERIAL

General Discourse on the Five Spheres and the Eight Boundaries Diagram of the Five Spheres [Mnemonic Rhymes on the] Diagram of the Five Spheres Diagram of the Eight Boundaries [Mnemonic Rhymes on the] Diagram of the Eight Boundaries T h e Six Bowels T h e Five Viscera Generation and Control among the Five Phases [The Relationships o f ] O u t e r and Inner among the Five Viscera [and Their Respective Bowels] T h e T h r e e Yin Conduits and the T h r e e Yang Conduits T h e Seven Affects [The Five Liquids] [The Five Flavors] T h e Four Q i

130 133 134 135 137 140 140 140 140 141 141 142 142 143

T H E N O SO G R A P H IES

11.18. Ni. N2.

T h e Eighty-one Nosographies R e d vessels spread from the inner canthus onto the eyeball Red vessels spread f r o m the outer canthus onto the eyeball

144 145 149

CONTENTS

N3. N4. N5. N6. N7. N8. Ng. Nio. Nil. N12. N13. N14. N15. N16. N17. N18. N19. N20. N21. N22. N23. N24. N25. N26. N27. N28. N29. N30. N31. N32. N33. N34. N35. N36. N37. N38. N39. N40. N41. N42. N43. N44.

Proud flesh creeping onto the eyeball The cock's comb or clam flesh [affliction] The two eyelids stick together Sticky and thick slime and tears Clean and clear slime and tears Black specks [resembling] fly wings The eyes turn dull and develop specks Eye secretion [caused by] extreme [internal] heat The flesh of the upper lid becomes sticky and stiff Ulceration on the upper lid Granulations of the lower lid Epidemic red eye Shade after a severe course [of the preceding affliction] Sudden red eye with shade Sudden [affliction of the eye due to] wind and external heat Pain as if possessed by a spirit Pain as if stung by a needle Outer obstruction after a heat disease due to harm caused by cold Wind pulls the lower lid outward Wind pulls eye and mouth into a slanting position Injury caused by a blunt object Shade following a stabbing Blood pours into the pupil A blood shade covers the eye Sty on the lower lid Pearl-like black shade Painful crab eye Helical protrusion Protrusion of the eye Rigid lids and rigid eyes White dimple with fish-scale pattern Patterned shade with white dimple Shade resembling a flaw inside a piece of jade Inconstant jade-colored shade A membrane intrudes into the water-sphere Spikelike shade on the wind-sphere A drooping yellow membrane A drooping red membrane A shade developing from two opposite directions Discharge of pus and blood from the eye Dust flown into the eye Eyelashes turning inward

Ml

152 154 158 161 162 164 165 167 168 170 172 173 175 177 180 183 186 188 190 193 196 197 199 202 204 205 207 209 210 212 213 216 218 220 222 224 226 229 230 232 233 236

via

CONTENTS

N45. N46. N47. N48. N49. N50. N51. N52. N53. N54.

Lacrimation due to the intrusion of wind Liver-wind and accumulation of heat Appearance of specks when one is rising from a seat Low vision at dusk Withered and deformed pupil Unbearable itch Itching eye caused by wind Shade like a hanging curtain Staring hawk-eye A windlass unwinds

239 241 244 247 249 251 253 254 255 257

N55. N56. N57. N58. N59. N60. N61. N62. N63. N64.

Eye with [mutual] penetration [of pupil and iris] in children Smallpox in children Shade in the eye in children Smallpox enters the eye Sparrow-eye in children Redness and festering resulting from uterine wind Malnutrition-harm in children Redness of the lid margins resulting from wind D i m vision with eye pain resulting from liver-wind Lacrimation when facing the wind

259 261 264 266 268 271 273 277 281 283

E S S E N T I A L S U B T L E T I E S ON T H E S I L V E R S E A , V O L U M E

N65. N66. N67. N68. N69. N70. N71. N72. N73. N74. N75.

R e d glow of the setting sun M o r n i n g pain Afternoon pain Extreme pain with aversion to cold Stagnant blood retained in the lids Pain without redness Redness without pain Redness transmitted from left to right Redness transmitted from right to left Lid-swelling resembling a peach Inexact vision

Virgin's menstrual blood flowing contrary to its normal course N77. R o u g h and aching eyes during menstruation N78. T h e white part of the eye turns yellow or red N79. Eye affliction with headache N80. T h e eye can see what is far but not what is near N81. [no title; on myopia] [Supplement to N61]

TWO

285 287 288 290 292 293 294 296 297 299 300

N76.

302 304 305 310 317 318 319

CONTENTS MISCELLANEOUS

ix

TOPICS

11.19.

[Collection of 106 prescriptions (P1-P106) Including a

11.20. 11.21.

Section (on) the T h r e e (Types o f ) T e a r s ] S u m m a r y o f Important [Issues C o n c e r n i n g ] the Five Viscera [Examination of the Pupil]

321 380 381

11.22.

[List o f Indications for C e r t a i n Prescriptions]

382

11.23.

O r a l l y T r a n s m i t t e d and Verified Instructions on the Examination o f Disorders

388

11.24. 11.25.

[ T h e Different T y p e s o f ] H e a d W i n d [ T h e Different T y p e s o f ] T e a r s

395 395

11.26.

Secret Instructions on [Indications o f D r u g s by] Differentiating the Disorders

396

11.27. 11.28.

Discourse on the Transmission of Disorders to the Eye through C o n d u i t Vessels C o m m o n Examination o f the Eye

398 401

11.29.

C o m m o n [Criteria for the Prognostic] Evaluation o f Shades

401

11.30.

C o m m o n Pattern o f C a u t e r i z a t i o n

402

11.31.

M e t h o d o f the Application o f C l a m p s (P107)

402

11.32. 11.33.

T h e Surgical M e t h o d with the G o l d e n Needle Invocation to G u a n - y i n

403 405

11.34.

Classification Patterns for the Use o f D r u g s in Ophthalmology Verses on Effective Prescriptions and Drugs in [Surgery with the] G o l d e n - N e e d l e in O p h t h a l m o l o g y Discourse on the Blending o f Elixir Medications M e t h o d for Refining Zinkspar (P108-P109) M e t h o d for C o m p o u n d i n g the Y i n Elixir (P110-P118) Important Patterns for the Effective C o m p o u n d i n g of Elixirs (P119-P125) O i n t m e n t s for L o c a l A p p l i c a t i o n at the Eye Against the V a r i o u s E y e [Afflictions] (P126-P134) O n the N a t u r e of Drugs A n o t h e r Prescription for a Locally A p p l i e d M e d i c a t i o n

11.35. 11.36. 11.37. 11.38. 11.39. 11.40. 11.41. 11.42.

(Pi 35)

406 408 419 422 423 431 434 438 463

APPENDICES

1.

A l p h a b e t i c List of D r u g s O c c u r r i n g in the Tin-hai jing-wei

465

2.

Literature U s e d in the Identification of D r u g s

479

*

CONTENTS

BIBLIOGRAPHY

1. 2. 3.

Primary Chinese Sources Secondary Sources in Chinese Secondary Sources in Western Languages and Japanese

481 482 484

4.

Editions of the Tin-hai jing-wei Collated for the Present Translation

488

Index of Prescriptions, Chinese Index of Prescriptions, English General Index

491 495 499

PREFACE

The Yin-haijing-wei is a classical text of traditional Chinese ophthalmology, compiled in its present version in or around the fifteenth century. For the past three hundred years, the authorship of the Yin-hai jing-wei has been assigned to the famous Tang physician Sun Si-miao, an association that does not withstand historical scrutiny. Obviously different traditions of thought and clinical practice were collated in this book. The Yin-hai jing-wei is offered here in a strictly philological translation. At a time when an interest in approaches to illness and healing different from those developed in Europe and North America has directed attention to Chinese medicine, it is most important to carefully analyze the historical origins of a health care that is seen by many as a possible alternative to current Western paradigms. The Yin-hai jing-wei is a rich source of a subspecialty of Chinese medicine lending itself to far-reaching comparisons: first, of physiological, pathological, and clinical knowledge concerning the illnesses of the eye as developed in China and the West; second, of more general issues in the history of medicine and science in China and the West; and, third, of the images widespread in the West of Chinese medicine on the one side, and their historical facticity, on the other. The Yin-hai jing-wei offers valuable insights into the problematic relationship between notions of function and morphological structure in traditional Chinese medicine, as well as into the integration of foreign (mainly Indian) concepts and practices into ancient Chinese ophthalmological reasoning and health care. The text does not contain a single reference to acupuncture, a therapeutic method so closely identified with Chinese medicine today. Rather, it provides ample evidence of the importance of surgical interventions in the treatment of the eye. The most prominent mode of therapy advocated in the Yin-hai jing-wei, though, consists in the application

xi

xii

PREFACE

o f a w i d e v a r i e t y o f h e r b a l , m i n e r a l , a n d a n i m a l substances. C l i n i c i a n s o f traditional C h i n e s e m e d i c i n e m a y find it w o r t h w h i l e to e x a m i n e the internal a p p r o a c h to the t r e a t m e n t o f n u m e r o u s eye afflictions c h a r a c t e r i z i n g this text. In its transmission t h r o u g h the centuries, the Tin-hai jing-wei has b e e n r e p r i n t e d in n u m e r o u s editions, d o c u m e n t i n g the w i d e s p r e a d a p p e a l o f this text to C h i n e s e practitioners. T h e present translation is b a s e d o n a synopsis o f five different editions (see the B i b l i o g r a p h y ) , with o c c a s i o n a l r e f e r e n c e to still others. A l l t e x t u a l d i f f e r e n c e s h a v e b e e n p o i n t e d out in the notes a c c o m p a n y i n g the translation. T h e a u t h o r s a c k n o w l e d g e w i t h g r a t i t u d e the

financial

support received

f r o m the G e r m a n R e s e a r c h A s s o c i a t i o n ( D F G g r a n t no. U n 33/8-1) to cond u c t this r e s e a r c h . T h e inclusion o f the o r i g i n a l C h i n e s e text o f the Tin-hai jing-wei in this b o o k w a s m a d e possible b y a g e n e r o u s g r a n t (SP 013-924) b y the C h i a n g C h i n g - k u o F o u n d a t i o n f o r I n t e r n a t i o n a l S c h o l a r l y E x c h a n g e . S p e c i a l thanks go to P r o f e s s o r N a Q i for his assistance in p r e p a r i n g a c o p y o f the b l o c k - p r i n t e d e d i t i o n o f the Tin-hai jing-wei kept in the N a t i o n a l C e n tral L i b r a r y in T a i b e i , a n d to D r . A k i r a A k a h o r i for o p e n i n g to us access to the J a p a n e s e e d i t i o n kept in the K y o u s h o y a in O s a k a . W e h a d the p r i v ilege o f discussing i n d i v i d u a l passages o f o u r translation with c o l l e a g u e s in C h i n a , J a p a n , a n d the U n i t e d States, a n d w e should like to thank t h e m for all the a d v i c e r e c e i v e d . M u n i c h , M a y 1997 Jürgen Kovacs Paul U. Unschuld

Introduction

I.l. THE YIN-HAI

JING-WEI

No organ is comparable to the eye in its importance as a link between man and his environment. T o be deaf, or to have lost dermal sensitivity—such handicaps are severe and create a definite obstacle to the perception of the world we live in. When sounds do not reach us, and when hot and cold, soft and hard, smooth and rough cannot be distinguished, a significant segment of all the stimuli and impressions reaching us from our environment, tying us to our environment, and permitting us orientation in our environment is lost forever. Similarly, to be mute is more than merely to have a silenced voice; muteness is a barrier closing one of the natural outlets of our mind to express our thoughts and to convey our sentiments. Loss of a sense organ and loss of voice entail invisible but nevertheless strict and lifelong incarceration; far-reaching isolation is the result. No such impairment, though, equals blindness. With our eyesight destroyed, our communication with the social and physical world is interrupted in two ways. We know each other from our eyes; to disguise us it is sufficient to mask our eyes. Also, our intangible characteristics are most closely associated by our fellow human beings with signals read from our eyes. In our assessment of another person's character and emotions, we depend on a feeling of being able to look into this person, and this feeling is possible only as long as the eyes of our counterpart are "alive," as long as they appear to reflect internal assets. Once the eyes are blinded, it is as if an entry into the mind and nature of a counterpart has been closed. If, therefore, "dead eyes" create a distance between the blind and the seeing from the perspective of the latter, the same is true, but much more intensely, for the blind person and that person's perception of the world. Both this world, and—in literate civilizations—the written media relating 3

PROLEGOMENA

its description, analysis, and meaning, remain hidden to the blind, remain even physically inaccessible, if there is no help from those who see acting as interpreters or guides to enable movement, mentally and physically. A n d even if interpreters who tell of the world and guides who lead one through the world are available, such assistance remains of a very limited v a l u e — i t cannot bridge the gap. Blindness is not a cultural construct. Blindness is a fact with identical primary consequences all around the world. Blindness may h a p p e n — o u t of accident or through an illness—to anyone anywhere. H u m a n reaction to blindness, or to impending blindness, though, is culturally conditioned, as are many of the causes leading to blindness. Hence, in a cross-cultural comparison, a question of interest to the anthropologist is whether blindness, and the threat to turn blind, have received similar attention in different cultures, and whether the illnesses of the eye, as the physical organ whose faculties are involved here, have been viewed with similar attention in the medical traditions of such seemingly separate and idiosyncratic culture spheres as are Europe and China. After all, literacy predated medicine in the East and in the West, and the very authors compiling medical literature could have read and written their texts without ears, or voice, but hardly without eyes. With the present study, we wish to introduce a major text from the history of traditional Chinese ophthalmology to a Western readership. This text, the Yin-hai jing-wei M i S f i t ® (lit-. "Essential subtleties on the silver sea"), 1 traditionally ascribed to Sun Si-miao (581-682?), was most likely compiled from different sources in the fourteenth or fifteenth century (a detailed discussion of these dates will follow below). It combines lengthy theoretical passages with extensive sections recommending pharmaceutical prescriptions and other means of therapy; its contents permit an analysis of the conceptualization of eye afflictions and of the physiology of the healthy eye in traditional Chinese medicine, and it offers insights into foreign (here Indian) influences on health care in China. O n a meta-level, the Yin-hai jingwei is an example of an outstanding text from the realm of distinct specialties within traditional Chinese medicine. T o open its contents to an audience that is separated from the culture and the author(s) who produced these c o n t e n t s — n o t only by vast geographical distances but also by a time span of more than half a millennium—requires a thorough discussion of the methodology chosen and the terminology to be adopted. Traditional Chinese medicine is a cultural product that was never static or homogeneous. Traditional Chinese medicine consists of many historical layers and ideological traditions, and while the Yin-hai jing-wei itself reflects this heterogeneity to a certain degree, it should be seen as one little—albeit i m p o r t a n t — p i e c e in that slowly unfolding mosaic of thoughts and practices which only in its entirety m a y be called traditional Chinese medicine. It is

INTRODUCTION

our task as medical historians, through translating and analyzing ancient Chinese medical texts, to permit, or at least strive to permit, unprejudiced access to a field of data the major part of which will remain hidden from our eyes for a long time to come. Given the fact, though, that almost the entire secondary literature on Chinese medicine published in the West over the past two decades was written with an eye to providing clinical information by authors perceiving a need to present, under the name of "Chinese medicine," approaches to health care and conceptualizations of illness either not existing or neglected in Western medicine, it is hardly surprising that this literature has been quite selective. Fields such as pediatrics or ophthalmology have not been treated adequately in recent accounts of "Chinese medicine." Where guiding interests aim at a presentation of a "Chinese medicine" that fulfills the two criteria of being an alternative to so-called Western medicine and, at the same time, of remaining within realms of thought that are neither absurd nor metaphysical nor outright disproven and obsolete if judged from a contemporary scientific perspective, traditional Chinese medical specialties, such as ophthalmology or pediatrics, appear—at least on first glance—rather unappealing, and they have been widely neglected until recently. The Yin-hai jing-wei offers, as we shall see below, an approach toward understanding and curing eye disorders that makes ophthalmology, apart from its surgical components, appear—from a twentieth-century perspective—as a subspecialty within internal medicine rather than as a distinct specialty within medicine. Regardless of the stimuli an in-depth examination of this approach may exert on clinical ophthalmology in the future, the Yin-hai jing-wei is an important historical document. A familiarity with its contents will contribute to the gradual unveiling of the complete mosaic of traditional Chinese medicine.

The Eye and Eye Afflictions in China— Historical Retrospection

1.2. EARLIEST EVIDENCE The "evil eye," a concept so ubiquitous in central America, Southern and Middle Europe, North Africa, the Near East, and Southeast Asia, has not been documented, to any significant degree, in historical China (Maloney 1976, 293, 295). The power to harm or kill, motivated by envy or revenge for oppression, was not associated with the eye in China; the Chinese analogue for the evil eye was the concept " g u " H , a technique of black magic whereby a poisonous insect, manifestation of a spirit, served the oppressed and the greedy to harm their oppressors and the rich (P. Unschuld 1985a, 46-50). Why, we may ask, did the concept of the evil eye spread only to the borders of China and fail to enter China? There is no answer to this unless we assume that the concept of " g u " has replaced an earlier concept of evil eye in prehistoric China. In fact, Shirakawa Shizuka jl I j|P has been able to establish a link between the power attributed to the eye and that attributed to gu magic. Shang era oracle bone inscriptions speak of three thousand girls with eyebrows painted in an exaggerated manner on their foreheads (obviously meant to enlarge the eyes and increase their impact) who were deployed prior to a battle to shout and direct the destructive force of their eyes at the enemy. 2 The dynastic history of the Han, the Han shu fH H , notes three occurrences of "the way of the eyebrows-seduction," mei dao 5 1 all with reference to women in the imperial harem who were accused of practicing evil magic (Shirakawa 1976, 444). Shirakawa argues that "the way of the eyebrows" and gu refer to the same phenomenon. The difference is that gu focuses on the materialized source of the evil power, while " e y e b r o w " refers to the person, or the actions of that person, who works the magic. In this context it may be noteworthy that the oldest decipherable pictograms known from China, on pottery found in Jiangxi, Henan, and Hebei 6

T H E E Y E A N D EYE A F F L I C T I O N S IN C H I N A

Figure i. Early Chinese graphs depicting the eye. Above: Hand-copy of an inscription from Wucheng with an eye in its center. Below left: Rubbing of a graph from Zhengzhou. Below right: Rubbing of a graph from Taixicun, Gaocheng. (All figures reproduced here from Keightley 1983, 340, 344, 345.)

and dating back to the eighteenth and seventeenth centuries B.C., appear to include graphic depictions of two body parts of outstanding significance: the eye and the hand. T h e contextual meaning of these graphs is unknown, and hence it is impossible to decide whether the eye was inscribed here for magical purposes, as a potter's mark, or perhaps as a reference to the visual organ itself and its perceived functions. 3 It is only from sources dating more than half a millennium later than these pottery j a r s — t h a t is, from the oracle bones and turtle shells of the Shang of the thirteenth- to eleventh-century B.C.—that we find the " e y e " mentioned in a context that is both obvious and related to health care. T h e Shang era is the oldest period in C h i n a to have left sufficient written documents and other material traces enabling an identification of some of its rulers as historical personalities and allowing for an exact periodization at least of its final centuries. T h e social structure of the Shang appears to have included the living and the dead, and the Shang knew how to exchange questions and answers between these two groups. For this purpose, they utilized a system of communication handed down from at least the fourth millennium B.C. M a n y records of this system have been preserved until our own time. Beginning in 1899, and especially in the years between 1928 and 1937, tens of thousands of inscribed oracle bones (usually bovine scapulae) and turtle shells were unearthed in the vicinity of A n y a n g in the province of Henan. Virtually all these bones and turtle shells carry inscriptions concerned with information required by the royal court from the dead, that is, from the ancestors. These include official state affairs, such as military campaigns, building projects, sacrificial rituals, weather forecasts, and harvest estimates, and they also pertain to what we might

8

PROLEGOMENA

be tempted to call personal problems of the king and his immediate entourage, such as questions concerning dreams, births, health, illness, and death (P. Unschuld 1985a, 17-28). While the Shang appear to have conceptualized only one single "disease," that is, disharmony in the relationship between the living and the dead, this disease was considered to manifest itself in many illnesses or pathological conditions, including physical, mental, and social handicaps affecting individual community members or the living in their entirety. As far as health problems were concerned, the information requested by the living from the dead was related to correct diagnosis of an illness, to its prognosis, and to its treatment. The latter was seen as being in the power of the dead only; that is, mainly through appropriate sacrifices, the living were known to be able to propitiate the dead and cause them to withdraw an onus or reestablish a harmonious relationship in some other way. On the oracle bones and shells related to health issues, the nature of the disease remained implicit; it was known but not specified in words and characters. All we read of today are the illnesses inflicted on the living by their ancestors. They were depicted by combinations of graphs representing "illness" and the body part afflicted. Hence, oracle inscriptions requesting information concerning the eye affliction of some member of the royal court include the compound composed of the two characters ji for "illness," "affliction," and mu for " e y e . " It is noteworthy that the development of Chinese script had proceeded to a stage by the time of the twelfth and thirteenth century B.C. where the graph for " e y e " appears not only as a solitary pictogram but as part of composite characters designed to express such meanings as " t e a r s " or " t o see." Examples of oracle inscriptions directed at the ancestors, and asking for information concerning what might be called ophthalmological problems today, read as follows.* jin dan wangji mu H. EE i! lit.: Now morning king illness eye or: This morning the king is ill because of his eye or: This morning the king has an eye affliction zhen ziyuji mu ^ i 1 ^ H lit.: Inquiry Zi Y u illness eye or: Inquiry concerning the eye affliction of Zi Y u (the son of King Wu-ding; traditionally dated 1 3 2 4 - 1 2 6 6 B.C.) Several other oracle bone inscriptions include the pictogram for " e y e " paired with that for "illness." However, their meaning is not entirely clear, and one should resist, at least for the time being, a temptation to assign them an ophthalmological meaning.

THE EYE AND EYE AFFLICTIONS IN CHINA

g