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In most humoral systems of medicine, bloodletting forms one of the central methods of evacuating humors from the body. Chinese medicine is no exception. While it is well known and undisputed that bloodless acupuncture has largely replaced an early tradition of bloodletting, has also preserved a 'little tradition' of bloodletting in the form of wet cupping and pricking that is still widely practiced today. Yet unlike the classical Āyurvedic and Greek medical traditions, which associate blood quite closely with humors, early Chinese medicine does not mention blood in connection with phlegm (the most important humor in the Chinese tradition). This changes in the Song dynasty, in conjunction with a larger shift in Chinese medical theory. The first texts to associate blood with phlegm are found in Song (960-1279) and Yuan (1271-1368) dynasty texts, where blood starts to behave in similar ways as phlegm in forming obstructions (such that phlegm or blood could block the heart orifices in very similar ways (痰/血迷心竅), stagnations (痰/血鬱), and corrupt matter (敗，惡物 ). Blood also starts to directly interact and mingle with phlegm: phlegm could carry blood and vitiated blood could turn into phlegm. This paper will trace the emerging connection between phlegm and blood in postclassical Chinese medicine, identify some of the factors which caused it, and consider how this connection implicated the experience of the body in the world.
Natalie Köhle
Hong Kong Baptist University, Hong Kong