The Doctor, the Scholar (and the Meditator?) 
in Middle Period China

Stephen Boyanton
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A doctor, a scholar, and a meditator walk into a bar… and they’re the same person!

This (admittedly rather bad) joke flitted into my head while we sat together on a grey October day at Johns Hopkins’ Institute for the History of Medicine discussing the frequent but frequently fraught intersections of meditation, healing, and the scholarship that claims to understand these two. The joke occurred to me as I pondered whether the people I study as a historian—Chinese elite doctors of the Song (960-1279), Jin (1115-1234), and Yuan (1271-1368) dynasties—would share my feeling of anxiety over whether and how these three parts of my life fit together. All three of these activities play important roles in my life. As a historian, practitioner, and teacher of Chinese medicine, I can unembarrasedly claim some form of expertise in both scholarship and healing, and while I would never presume to be an expert in any form of meditation, it has been a part of my life for more than twenty-five years. It was meditation that led to my interest in Asian cultures and religions, which led in turn to my interest in Chinese history and medicine. From the beginning, these three were aspects of one thing in my life, but when forced to contemplate them side-by-side, as I was that autumn day, I couldn’t deny the sense of disjuncture I was experiencing. Would my Chinese predecessors have shared it?

My instinct was that they would not. After all, a good elite physician was supposed to be a gentleman, and a good gentleman was supposed to be, or at least affect to be, a scholar of the Chinese literary, historical, and philosophical tradition. Neither was there any dearth of reasons for a gentleman to meditate. Chan Buddhism (禪, better known by its Japanese name: Zen) was a living influence on elite society in this period, and many proponents of the Confucian movement, the Learning of the Way (Daoxue 道學), encouraged a meditative form of self-cultivation known as “quiet sitting (jingzuo 靜坐).” Furthermore, various forms of Daoist meditation, aimed at promoting health and longevity, were suitable practices for gentlemen, and this period saw the emergence of several new Daoist movements and meditative techniques for which the literati-elite were the primary audience and practitioners. There was, then, ample social sanction for an elite physician to also be a scholar and meditator. In fact, it might even seem odd if they were not. Surely, then, the doctors I study were happily exempt from my distress.

But were they? Is social sanction enough to prevent activities from feeling dissonant with each other? After all, my broad knowledge of Chinese medical literature elicits no objections from my colleagues in either academia or medicine. Whether as a historian or a practitioner of Chinese medicine, such knowledge is seen as an asset. What occasionally raises eyebrows among both practitioners and academics is not what I know, but who I am: the problem is that I am both a historian and a clinician. By the same token, although a knowledge of medicine—which could be used benevolently to help family, friends, and neighbors—was a praiseworthy accomplishment for a Chinese gentleman, my own and others’ research has shown clearly that elite society continued to view the practice of medicine as an unworthy occupation, even as more and more elite men took it up out of necessity. Gentlemen-physicians felt the need to defend their choice of career, and many only turned to medical practice only after failing at the far more prestigious career of government official and man of letters. So even in middle-period China, being both a doctor and a scholar was potentially fraught.[1]

What, then, of being a meditator? In the following sections, I examine the different contexts in which an elite doctor might have meditated. I have ignored the vast terrain of meditation as part of Buddhist or Daoist ritual for the simple reason that few elite doctors were also ritual practitioners of this sort. They relied on other, generally sub-elite ritualists when such services were necessary. For the sake of convenience, I will use the term meditation in its typical modern sense—any practice involving a quiet focusing of the mind—but this usage is highly problematic in the time and place I am discussing. I will return that problem at the end of this essay.


Sitting in Chan to Obtain the Way

For many years scholars took it as given that during the Song dynasty, Buddhism entered a period of decline from which it never recovered. Although monasteries continued to thrive and grow, the ideas and practices of this degenerate Buddhism were said to lack the creativity and vitality that characterized Buddhism under the Sui (581-618) and Tang (618-907) dynasties. Buddhism, if it retained any social significance, did so only among commoners. It was no longer a living force among the elite.[2]

Fortunately, scholarship over the last twenty years or so has done a great deal to correct this appraisal of Buddhism’s place in middle period China. Far from a period of decline, the Song Dynasty was one of the most dynamic periods of Chinese Buddhist history. It differed in many ways from preceding periods—most notably in that new developments were no longer coming from India but from within Chinese Buddhism itself—but it remained an active part of the life of the elite as well as commoners. Members of the literati-elite continued to visit, support, and contribute to the founding and repair of Buddhist temples and monasteries. Most importantly for the current topic, they continued to practice Buddhism, and for many of them such practices were real and relevant in their lives.[3]

Two forms of Buddhist meditation were particularly popular with the middle period elite: Chan and Pure Land (jingtu 淨土) meditation.

Chan meditation itself existed in two forms during this period, which came to be known as silent illumination Chan (mozhao Chan 默照禪) and phrase-observing Chan (kanhua Chan 看話禪). Silent illumination meditation was based on the idea that the quieting and stilling of the mind would allow the meditator to awaken to enlightenment. The practice was frequently described as “just sitting (zhiguan dazuo 只管打坐)” and became characteristic of the Caodong (曹洞, Jpn. Sōtō) branch of Chan. Phrase-inspecting meditation involved focusing on an enlightened conundrum expressed in a gongan (公案, lit. public case; Jpn. Kōan). Gongan were usually records of interactions between Chan masters and their students involving some logically inexplicable element. After meditating deeply on the heart of this conundrum, the meditator’s mind would make the leap to direct perception of a solution that could not be expressed in unenlightened words. The Chan masters who established these two approaches as distinct and separate were popular figures with large followings among the elite at a time when elite support was particularly crucial to the survival of Buddhist institutions, and it has been argued that the differentiation of these two approaches owed more to Chan teachers’ need to distinguish themselves in a competitive religious marketplace than it did to doctrinal or other intra-Chan disputes.[4] Regardless, the literati-elite were clearly the main audience for and practitioners of these kinds of meditation.

From their inception, soliciting elite support was one of the purposes of Song Dynasty pure land societies. These groups, formed in imitation of a society founded long before by the revered monk Huiyuan (334-416), were organized to provide support for Buddhists seeking to be reborn in a pure land (jingtu), the paradisiacal realm inhabited by a Buddha. In particular, devotees sought rebirth in the pure land of Amitābha Buddha (Emituofo 阿彌陀佛; Jpn. Amida Butsu). Pure Land practice focused on “Buddha-mindfulness meditation” (nianfo sanmei 念佛三昧; Skt. buddhānusmṛti samādhi). This term initially referred to the mental recollection of a Buddha, but over time came to be increasingly associated with recitation of a Buddha’s name. Although Buddha-mindfulness became one of the most widespread forms of meditation in China—embraced by all social strata—it originated in an effort to bring in more of the literati-elite and remained a common practice among them[5]


Quiet Sitting and Active Study

The religious movement for which the Song is most famous is without doubt the Learning of the Way (often called Neo-Confucianism). Founded on the teachings of the Cheng brothers—Cheng Hao (程顥, 1032-1086) and Cheng Yi (程頤, 1033-1107)—the Learning of the Way was part of a more general Confucian revival during the Song. Its supporters decried the moral degeneration of their times and sought to create a society founded on the teachings of the legendary sage-emperors of Chinese antiquity. To the existing Confucian literature, Learning of the Way scholars added a more sophisticated vision of cosmology that rooted Confucian morality and self-cultivation in the very nature of the universe. They sought a higher goal than merely becoming a refined and moral gentleman (junzi 君子), proclaiming that it was possible to become a sage (sheng 聖)—a human who understood and accorded with the true nature of things and therefore responded perfectly to all situations and was a supreme source of guidance to all around him. They also created new rituals and social institutions designed to bind families and communities together as morally active communities.

As in all forms of Confucianism, study and learning had a central place in the Learning of the Way. What is less well-known is that a form of meditation called “quiet sitting” was also central to Daoxue’s practices. In particular, Zhu Xi (朱熹, 1130-1200)—whose interpretation of the Learning of the Way would ultimately become state orthodoxy—stressed the importance of this practice. For Zhu, quiet sitting was an essential step in the process of true learning:

When you first begin the effort of studying, what is necessary is quiet sitting. If you practice quiet sitting, the foundation [of your learning] will be stable.[6]

Quiet sitting made one ready to learn and kept one in a receptive state:

If the spirit is not stable, then the principle of the Way has nowhere to gather.[7]

Zhu was aware that what he was prescribing to his students appeared superficially similar to Chan meditation, but he was adamant that in its essence it was quite different:

In quiet sitting, it is not the case that you want it to be like sitting in Chan [meditation] and entering samādhi. Just restrain this mind. Under no circumstance fall into [the error of] guarding against thoughts. Thus, this mind will be clear and still, without affairs, and naturally become concentrated. If affairs arise, then it will respond in accord with the affairs. When the affairs are complete, it will again become clear and still.[8]

Quiet sitting was a more relaxed affair than Chan meditation and could be performed anywhere. Its goal was not so much a spontaneous awakening to truth (although some Daoxue supporters did advocate this kind of realization),[9] but acquiring a receptiveness to learning and a readiness to respond to situations appropriately and effectively.


Nourishing Life and Seeking Immortality

Of all the forms of meditation elite doctors would have likely encountered, none has such a clear bearing on health and healing as the practices designed to nourish life (yangsheng 養生) and seek immortality (xiuxian 修仙). By the Song Dynasty, most of these practices were firmly associated with Daoism, whatever their origins, and the appearance of new Daoist movements in this period facilitated the spread of these meditative techniques among the elite.

Strictly speaking, there was no clear line between nourishing life and seeking immortality. Both were largely conceptualized in terms of longevity (shou 壽). Thus one could strive to fulfill one’s allotment of one hundred years or one could strive for “longevity equal to that of heaven and earth.”[10] The methods involved differed considerably, but all were equally forms of nourishing life. Diversity was one of the hallmarks of this genre.

Many nourishing life practices had nothing to do with meditation. Manuals on dietetics, exercise, seasonal regimen, and other non-meditative methods of nourishing life enjoyed great popularity during the middle period. Other forms of nourishing life lay in the murky border between what we would call exercise and meditation: movements—subtle or gross—accompanied by specific visualizations, breathing exercises, practices of sexual cultivation, and so forth. Many techniques that we would see as unequivocally meditative existed as well.

There is not space in this paper to even survey the variety of Daoist meditative techniques common from the Song to the Yuan, so I will focus on a new movement that became highly influential from this time onward: internal alchemy (neidan 內丹). Internal alchemy was both a development of and a reaction against the older forms of physical alchemy—now often called external alchemy (waidan 外丹). In that practice, various minerals—most notably cinnabar and sulfur—were combined and heated in crucibles following very precise schedules in an effort to produce an actual, physical elixir of immortality. The advocates of internal alchemy rejected this quest as misbegotten. Only an elixir of the same nature as a human being could possibly lead to immortality, and such an elixir was only to be found within oneself, not in the external world.[11] The goal of internal alchemy was the generation of an insubstantial and immortal “embryo (tai 胎)” that was the adept’s true self and via which he would endure forever.

The practices of internal alchemy are complex, and they were made more inscrutable by authors’ habit of describing them in highly metaphorical language that drew on the trigrams of the Classic of Changes (Yijing 易經), the details of external alchemy, the technical language of Chinese medicine, and previous texts on internal alchemy. The profusion of symbolism and metaphor seems to actually be a part of the process of refining the elixir. Cloaked under such language, the texts of internal alchemy describe a plethora of meditative practices: stabilizing the concentration, breath control, internal visualization, guiding the qi and other fundamental substances of the body to circulate in particular ways, and more. Some of these practices, particularly in the later stages, resembled Chan meditation, but they were only one of a complex sequence of meditative practices designed to lead the adept to immortality and transcendence.[12]


Were There Meditators or Meditation in Middle Period China?

This is the sort of question you ask at the risk of being labeled a pedant, or worse. But it is precisely this sort of seemingly nitpicky detail that can ruin an otherwise excellent argument or offer a solution to an otherwise baffling conundrum. In my opinion, the question I posed in the introduction—“Would Chinese elite physicians of the middle period share my sense of dissonance between being a scholar, a clinician, and a meditator?”—can only be answered after considering this problem.

Although all of the practices described above would be called meditation today, there was no single term in Chinese that included all of them. Zhu Xi’s concern that students might confuse quiet sitting with Chan meditation clearly shows that he and others at the time recognized a similarity between the two practices. But was this a superficial similarity of appearance or a generic similarity in the type of activity being performed? This question goes far beyond the topic of this essay, but I would suggest that Zhu Xi’s argument was that the substance of quiet sitting differed fundamentally from that of Chan. The two were not different forms of the same activity, but distinct activities whose outward manifestations appeared similar.

If Zhu Xi’s opinion is generalizable to the rest of elite society, then Chan meditation, quiet sitting, and refining the elixir of immorality within one’s body were not species of the same genus, but separate genera altogether. There was no “meditation” in middle period China, and therefore there was no overall category “meditators.” Moreover, these practices were deeply embedded in the particular teachings that gave birth to them. The identity of a practitioner was thus not vested in the individual practices, but in the teachings to which they belonged. A man who practiced quiet sitting was not a “practitioner of quiet sitting.” This social role simply did not exist. He was a practitioner of the Learning of the Way and a Daoxue Confucian—and likewise for people who practiced Chan meditation or internal alchemy. The men I study, therefore, were doctors and scholars, but they were not meditators.

The English term “meditation” has come to refer to a bewildering array of practices that have little genuine similarity with one another. It is not unlike the problems with another word, “shaman,” that has presented interpretive problems for historians of China. But while scholars have already taken that word to task,[13] “meditation” continues to run amok in our discourses, wantonly conflating unrelated activities. All of the practices discussed in this paper originated in one region within roughly a century of one another, and yet they differed greatly in their rationales, their goals, and in what their practitioners were actually doing. The only real similarity between them is that their practitioners were often sitting down quietly. Can this really justify taking them as members of a single category?


Conclusion: “And one Man in his Time Plays Many Parts”

I began this paper by wondering whether the elite doctors I study meditated, and if so, whether they would have shared my sense of uncomfortable disjuncture when forced to hold those roles simultaneously. Clearly, there were many situations in which these doctors might have engaged in practices we would call meditation. In fact, many of their day-to-day medical practices might also warrant that name. Anyone who has taken a pulse knows that it requires a great degree of inner calm and relaxed but concentrated attention. Is it so different from open awareness cultivated in silent illumination Chan? The art of crafting a medicinal formula also demands an inward contemplation and organization of vast amounts of memorized material. Is there no similarity between this and the inward visualizations of internal alchemy?

I also noted at the outset of this paper that it is my multiple identities, and not my activities per se, that occasionally cause discomfort or puzzlement to myself and others. It is perceived conflicts of social roles that lead to a sense of social dissonance. The elite doctors I studied experienced just that dissonance in juxtaposing their identities as physicians and scholars, but even if they were active participants in all of the practices described in this essay (not impossible, if unlikely), they would never have an identity as a “meditator,” because no such identity existed in their time. It is likely that they did have identities as Buddhists, Daoxue Confucians, and/or Daoists, but there was no necessary conflict between these identities and being a doctor and scholar. Therefore, while my doctors may have shared with me the difficulties of being both a doctor and a scholar, I can rest content knowing that they lived free of any anxieties regarding being a meditator—even if I cannot.

[1] Robert Hymes, “Not Quite Gentlemen? Doctors in Sung and Yuan,” Chinese Science, no. 8 (1987): 9–76; Stephen Boyanton, “The Treatise on Cold Damage and the Formation of Literati Medicine: Social, Epidemiological, and Medical Change in China 1000-1400” (PhD Dissertation, Columbia University, 2015).

[2] See, for example, Kenneth Chʻen, Buddhism in China, a Historical Survey, (Princeton, N.J.: Princeton University Press, 1972), 389–400.

[3] Peter N Gregory, “The Vitality of Buddhism in the Sung,” in Buddhism in the Sung, ed. Peter N Gregory and Daniel Aaron Getz (Honolulu: University of Hawai’i Press, 2002), 1–20; Chi-chiang Huang, “Elite and Clergy in Northern Sung Hang-Chou: A Convergence of Interest,” in Buddhism in the Sung, ed. Peter N Gregory and Daniel Aaron Getz (Honolulu: University of Hawai’i Press, 2002), 295–331; Mark Halperin, Out of the Cloister: Literati Perspectives on Buddhism in Sung China, 960-1279 (Cambridge: Harvard University Asia Center, 2006).

[4] Morten Schlütter, “Silent Illumination, Kung-An Intorspection, and the Competition for Lay Patronage in Sung Dynasty Ch’an,” in Buddhism in the Sung, ed. Peter N Gregory and Daniel Aaron Getz (Honolulu: University of Hawai’i Press, 2002), 109–47.

[5] Daniel A. Getz, “T’ien-Tai Pure Land Societies and the Creation of the Pure Land Patriarchate,” in Buddhism in the Sung, ed. Peter N Gregory and Daniel Aaron Getz (Honolulu: University of Hawai’i Press, 2002), 487–492.

[6] Categorized Sayings of Master Zhu (Zhuzi yulei 朱子語類, 1270), juan 12, xue liu, chishou, in Zhu Xi, Zhuzi yulei, ed. Li Jingde (Beijing: Zhonghua Shuju, 1986), 217.

[7] Ibid., 216.

[8] Ibid., 217.

[9] E.g., Ari Borrell, “Ko-Wu or Kung-An? Practice, Realization, and Teaching in the Thought of Chang Chiu-Ch’eng,” in Buddhism in the Sung, ed. Peter N Gregory and Daniel Aaron Getz (Honolulu: University of Hawai’i Press, 2002), 62–108.

[10] Awakening to Reality (Wuzhen pian, 悟真篇, ca. 1075), qiyan lüshi 10, in Zhang Boduan, Wuzhen Pian Qianjie, ed. Wang Mu (Beijing: Zhonghua Shuju, 1990), 16; translation adapted from Fabrizio Pregadio, Awakening to Reality: The “Regulated Verses” of the Wuzhen Pian, a Taoist Classic of Internal Alchemy (Mountain View: Golden Elixir Press, 2009), 52.

[11] Wuzhen pian, qiyan lüshi 8, in Zhang Boduan, Wuzhen Pian Qianjie, 14–15.

[12] Isabelle Robinet, Taoism: Growth of a Religion, trans. Phyllis Brooks (Stanford: Stanford University Press, 1997), 215–250; Wang Mu, Neidan yangsheng gongfa zhiyao (Beijing: Dongfang Chubanshe, 1990); Wang Mu, Foundations of Internal Alchemy: The Taoist Practice of Neidan, trans. Fabrizio Pregadio (Mountain View: Golden Elixir Press, 2011).

[13] E.g., Alice Beck Kehoe, Shamans and Religion: An Anthropological Exploration in Critical Thinking (Prospect Heights: Waveland Press, 2000).

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