Sun Simiao

Sun Simiao: The Physician Who Wrote the Oath

Halfway through a manual of emergency prescriptions, in a chapter about drugs and dosages, Sun Simiao stopped to make an argument nobody had asked him for. A great physician, he wrote, should not pay attention to status, wealth or age; he should meet everyone on equal grounds. That passage — "On the Absolute Sincerity of Great Physicians" — is now called the Chinese Hippocratic Oath and is still assigned to Chinese medical students. It was written in the year 652, and it was, in effect, a footnote.

The Hermit

Sun Simiao lived from 581 to 682, spanning the short violent Sui dynasty and the founding century of the Tang. He came from Tongchuan, in central Shaanxi.

The defining fact of his career is what he did not do. Chinese physicians of standing attached themselves to the court; Sun preferred life far away from it and lived essentially as a hermit. He was not entirely absent — he worked with Emperor Gaozong and probably with Empress Wu, though on Daoist studies rather than as a household doctor. But the arrangement was on his terms, and the distance was deliberate.

He was a devout Daoist who also studied Buddhism seriously enough that scholars describe him as a Buddho-Daoist, and he helped popularise the Avatamsaka school introduced by the monk Fazang. Fazang later wrote his biography — a Buddhist cleric memorialising a Daoist doctor, which tells you something about how little Sun cared for the boundaries.

A Thousand Pieces of Gold

His major work is the *Beiji qianjin yaofang* — "Essential Formulas for Emergencies Worth a Thousand in Gold" — completed and first published in 652. Thirty years later, at the age of about a hundred, he published a sequel, the *Qianjin yifang*. Together they are credited with roughly 5,300 and 2,000 formulas respectively; a specialist count of the first book gives around 3,500 remedies, ranging from single-drug treatments to combinations of as many as sixty-four ingredients. Ginseng alone appears in 445 of them.

The title is not boasting. It is a design brief. Sun explained his method directly: the formula books already in circulation were too massive to be any use in an emergency, so he deleted the complicated formulas and kept the simple ones. He was building a book a physician could open while somebody was dying — which is why it runs to thirty scrolls rather than three hundred, and why it is one of very few classical Chinese medical texts to include actual case histories, twenty-five of them.

The contents are laid out across twenty-nine sections after the introduction: gynaecology, wind-induced disorders, diseases of women and children, disorders of the seven orifices, qi disorders, cold-damage disorders, haemorrhoids, detoxification, acupuncture and moxibustion. He is credited with establishing gynaecology, paediatrics and geriatrics as distinct branches of Chinese medicine.

The Ethics

The introduction to the *Qianjin yaofang* covers diagnosis and treatment and then establishes a moral code for physicians — the first thing in the book, before any drug. Its demands are specific and physical rather than pious. The physician vows to rescue all living beings from their suffering and to work day and night, in cold and heat, in hunger, thirst and fatigue.

The equality clause is the radical one. In a society organised entirely around rank, Sun instructed the doctor to ignore rank: not status, not wealth, not age, everyone on equal ground. It is worth noting the tension with his own practice — many of his remedies close with the warning not to transmit them even for a thousand in gold. Universal duty of care, guarded proprietary knowledge. Both attitudes are in the same book.

The Alchemist

Sun also practised *waidan*, external alchemy — the manufacture of elixirs intended to confer immortality, which in the Tang meant heavy work with mercury and other metals. This was not a hobby separate from his medicine; the same pharmacological curiosity drove both. It also produced the strangest item in his record: a tenth-century historian claimed Sun's body did not decay after death because of the mercury he had ingested, a story that marks precisely where the historical figure begins dissolving into the cult.

Why Sun Is Called a Genius

The quality is editorial judgement joined to moral nerve. Sun Simiao did not discover a drug or propose a new physiology. What he did was recognise that the value of medical knowledge lies in its retrievability under pressure, and then act on that insight ruthlessly — cutting a vast inherited literature down to what a physician could actually use at a bedside, arranging it by the situation the doctor faces rather than by the categories of the tradition. Then he did something almost no compiler does: he wrote the ethics into the front of the manual, making conduct a technical requirement of the craft rather than a devotional afterthought. He was titled *Yaowang*, King of Medicine, and venerated as a patron deity of physicians; his ethics essay is still required reading.

The honest counter-case is that Sun is heavily encrusted with legend. A claimed lifespan of 101 years is at the edge of credibility for seventh-century China; the incorruptible-corpse story is plainly hagiography; and the two formula counts commonly cited, 5,300 and 2,000, do not sit comfortably with specialist counts of the surviving text. Both his books were re-edited by the Song official Lin Yi and colleagues and republished in 1066, so the version transmitted to us has passed through later hands. And his elixir work was, judged by its own goal, a complete failure — he was pursuing immortality with mercury. The genius on the record is organisational and ethical. The mystique is later.

Legacy

The books survived, re-edited, and became foundational. The ethics survived better. Sun Simiao is the figure Chinese medicine points to when it wants to claim a moral tradition of its own rather than an imported one, and his insistence that the poor patient and the rich patient are the same patient has outlasted every formula in the thirty scrolls.

He wanted to be left alone by emperors and he was. What he could not avoid was becoming a god: temples, the title King of Medicine, and a place among the deities to whom Chinese physicians still burn incense. For a man who spent a century avoiding the court, it is a peculiar promotion.

Achievements

• Notable work: Essential Formulas for Emergencies Worth a Thousand Pieces of Gold