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Be a good governor or a good doctor

CHEN ALONG | 2018-05-28
(Chinese Social Sciences Today)

Mencius’ teaching of “sharing joys and sorrows with the people of the world” greatly contributed to the sense of responsibility of ancient doctors.


The Buddhist teaching of mercy and relieving the distressed, the Taoist teaching of doing good deeds, and, especially, the Confucian teaching of benevolence and virtue were crucial spiritual pillars of ancient doctors’ career of saving the patients.


When he was young, Fan Zhongyan (989-1052), a famous politician in the Song Dynasty, once asked about his destiny by consulting the oracle of the Eight Trigrams when he was young. “Can I be a chancellor in the future?” he asked. The oracle said “no.” “Can I be a good doctor?” The answer was still “no.” Curious about the question he had just asked, someone nearby asked, “It was understandable that you want to be a chancellor. But isn’t wishing to be a doctor a little bit ambitionless?”

Fan sighed, “Serving the people as a chancellor is the best I can expect. Becoming a doctor is the second best thing I can do to help the people. As a doctor, I can cure the potential illness of the emperor and my parents as well as all the people in the world. Is there any better job than being a doctor?”

This is where the saying “Try to be a good governor, but if not [offered the opportunity], be a good doctor” originates. In fact, the teachings of Confucianism, Taoism and Buddhism greatly influenced Chinese doctors and medical culture ever since the Western Han Dynasty.


Sense of responsibility
Confucianism established for the scholar-officials an ideal life of “improving one’s personal virtues, regulating the family, governing the nation and pacifying the world.” Mencius’s teaching of “sharing joys and sorrows with the people of the world” greatly contributed to the sense of responsibility of ancient doctors.

The Confucian concept of ren, which means benevolence, requires the rulers to govern with benevolence and love for the people. Treating the patients with benevolence adheres to the Confucian teachings of ren. The saying “Be a good governor or a good doctor” indicates that, on the one hand, doctors who save the people should have high cultural literary and moral sense. On the other hand, being a doctor was also another important means for scholar-officials to realize their life value.  

Zhu Zhenheng (1281-1358), a well-known doctor in the Yuan Dynasty, once said, “Now that I am in a humble situation among the mountains and rivers, I can benefit very few people nearby. Through what other career aside from being a doctor can I influence more?” Saving the people with benevolence was the major motive for the doctors. Their aspiration to benefit the people manifested in their efforts to cure illnesses.

Zhang Zhongjing (c.150-c.215) was treated respectfully as the “Saint of Doctors” in China. In the preface to his masterpiece Treatise on Febrile Diseases, Zhang wrote “[Practicing medicine] in the higher sense will help cure the illness of the emperor and the parents; in the lower sense will help relieve the hardship of the poor and the humble; in the medium sense will help maintain a healthy life and longevity.”

Huangfu Mi (215-282), the author of China’s first systemic treatise on the science of acupuncture and moxibustion, stressed “Even if a person has loyalty and filial piety as well as benevolence and mercy, if they were not good at medical science, they would not be able to save their emperor or father who are in danger and distress, nor would they save their young children in anguish.”

Ye Tianshi (1666-1756) told his children when he was dying that “Unless you are of great gift and read a large number of medical books, you should not practice medicine. Otherwise, sooner or later someone will die because of you. You might be using medicine as blades to kill.”

When elaborating on his motive to write the Treatise on Febrile Diseases, Zhang Zhongjing said “[I] sigh at the death in the past and was saddened by the fact that people injured in accidents or getting sick at a young age would die because no one could save them.” It goes without doubt that doctors felt a strong sense of responsibility to save lives.

In terms of improving their professional knowledge, ancient doctors also spent their entire lives pursuing medical knowledge. Zhang Zhongjing said that he had diligently searched for ancient medical cases and prescriptions so that he could learn the treatment of all kinds of illness. According to the Book of Jin, Huangfu Mi immersed himself in the medical books and he often forgot to sleep and have meals. “His family was poor, and he often took the medical books to the farmlands where he could read them when he took a rest from the farm work.”

Sun Simiao (541-682), also known as the “King of Medicine,” read medical classics when he was young and “still would not lay down those books when his hair turned grey.” He sometimes traveled thousands of kilometers to learn the medical knowledge from those who were better than him in certain special areas. Dedicated to the medical career of saving the people, those famous doctors were modest and diligent when pursuing medical knowledge.

Medical knowledge and medicines directly related to the lives of the patients. Being rigorous and responsible when practicing medicine was a basic requirement for ancient doctors. Zhang Zhongjing severely criticized doctors who spent little time with a patient and were careless in diagnosis. Cui Moan (1802-1865) was an exemplary doctor in terms of sense of responsibility that he would examine the patient again and again until he figured out what was wrong with the patient.


Moral integrity
“The whole world as one community” was a vital political ideal of Confucianism. Selflessness was one of the crucial Confucian virtues. For ancient Chinese doctors, its doctrine is that a great doctor should prioritize doing what is right over personal material benefits. Sun Simiao said that a great doctor, when treating the patients, desires nothing personal. “Following the heart of mercy and sympathy, he would wish to save the people from suffering and anguish. He should not be enthusiastic about making money by using his medical techniques and knowledge,” Sun said.

Although the imperial court was always full of skilled doctors serving the royal family or the aristocrats, there were also many well-known doctors who would choose to live among the public and help the ordinary masses. Huangfu Mi chose to live in the countryside where he could focus on writing medical books. He refused the appointment of an official position by the government. Zhu Zhenheng did not avoid making friends with government officials. They would frankly talk about the political situation. But when talking about reputation and personal benefits, Zhu would feel offended and leave the house.

Pang An in the Song Dynasty was such a skilled doctor that many patients came to visit him. He emptied one room of so that those severely ill patients could stay there. He would personally attend to the decoctions. Not until the patients were fully recovered would he let them leave. Those cured patients would come back with gold and gifts to thank him, and he would only take the part he deserved. If he could not cure the disease, he would be frank with the patient.

When a medical student completed his apprenticeship, normally, the teacher would send him two gifts—an umbrella and a lantern—to remind him of the duties of a doctor. When recording the life story of Zhu Zhenheng, Song Lian (1310-1381) wrote, “Patients all around waited for Mr. Zhu in their homes round the clock. Mr. Zhu would set out immediately when he was needed. He would not stop even it rained or snowed heavily.”

“Barefoot doctors” are still common in some areas in China today. These local doctors usually take responsibility for the health of the people in several villages nearly. Whenever as well as whatever the weather is, once needed, a local doctor, following the footsteps of their ancient predecessors would take up the medicine cabinet and set out. The umbrella and lantern symbolizes Chinese doctors’ dedication to their job of saving people regardless of the weather and time.  

Pharmacies in ancient China normally hung a pair of sign boards with two couplets saying “Hope all the people in the world do not get sick, I would rather the shelves in my shop are covered with heavy dust.” This echoes the teachings guiding doctors that the health life of the people should be the primary concern to those who choose a career in medicine.  

Confucius once said “As a son, one should not know nothing about medical sciences.” The prominent doctor Xu Daoyou in the Southern and Northern dynasties became a doctor by reading a lot of prescriptions and cases because he looked after his sick mother. He told his children “How can a son uphold filial piety if he knows nothing about medical science when he should pay great attention to the medicine and food that is served to his parents?” Well-known doctors, including Li Dongyuan (1180-1251) and Zhu Zhenheng, all became doctors when someone in their family got sick or died of a certain illness.

Deeply rooted in traditional Chinese culture, medical culture upholds the medical ethics of prioritizing human life and a people-oriented philosophy. In addition to the rich medical theories and experiences that ancient medical scientists left us with, the humanistic values that they upheld are far more precious legacies that those who choose a career in medical circle should cherish.


(edited by CHEN ALONG)