Authors
Hanshin Kim
Published in
Ui sahak. Volume 35. Issue 2. Pages 731-770.
Abstract
Wushisan(Five-Stone Powder) was one of the most widely consumed mineral-based medicines from the Six Dynasties through the Tang period. Modern scholarship, however, has often portrayed it primarily as a symbol of aristocratic decadence and moral excess. This interpretation, shaped largely by the enlightenment discourse that emerged after Lu Xun and reinforced by modern biomedical perspectives emphasizing its toxicity and adverse effects, has tended to overlook why the medicine continued to be used for centuries and the therapeutic rationale and technical foundations that sustained its popularity. Rather than reducing the rise and decline of Wushisan to an intellectual or cultural phenomenon, this study reexamines its history from the perspectives of the material properties of the drug, contemporary medical practice, and the development of refining and paozhi(pharmaceutical processing) techniques for mineral medicines. Drawing upon medical texts such as the Jingui Yaolüe, Ishinpō, Zhubing Yuanhou Lun, and Beiji Qianjin Yaofang, together with historical sources including the Shishuo Xinyu, Jinshu, Nanshi, and Zizhi Tongjian, this article traces changing perceptions of Wushisan from the Six Dynasties period through the Song dynasty. The analysis demonstrates that physicians of the Six Dynasties regarded Wushisan as a superior medicine(shangyao) possessing remarkable therapeutic and tonic properties. Adverse reactions were generally attributed not to inherent defects in the medicine itself but to improper methods of administration and failures in post-treatment regimen. Consequently, medical discussions focused less on abandoning the drug than on maximizing its efficacy while minimizing its side effects through appropriate dosage, dietary regulation, and aftercare. During the Sui and Tang periods, however, physicians such as Chao Yuanfang and Sun Simiao began to explain these adverse reactions in terms of more systematic pathological mechanisms, shifting attention from the behavior of the patient to the material properties and toxicity of the medicine itself. This change did not entail a complete rejection of Wushisan but instead encouraged greater emphasis on refining mineral ingredients, improving pharmaceutical processing techniques, and standardizing prescriptions in order to control toxicity. By the Song dynasty, state-sponsored pharmaceutical standardization and increasingly sophisticated paozhi techniques enabled toxic mineral drugs to be prescribed in safer and more carefully processed forms. As a result, the traditional therapeutic logic of Wushisan, which relied on stimulating the body's internal release of medicinal potency after ingestion, gradually lost its medical legitimacy, while its therapeutic functions were absorbed into newly refined mineral medicines and standardized pharmacological systems. The disappearance of Wushisan should therefore be understood not simply as the elimination of a dangerous drug but as the outcome of advances in pharmaceutical knowledge, mineral processing technology, and state-sponsored drug standardization aimed at utilizing toxic minerals more safely and effectively. This study challenges the conventional view of Wushisan as merely a symbol of Wei-Jin cultural excess or the irrationality of premodern medicine. Instead, it reinterprets its historical significance through the evolution of medical knowledge and technological practices designed to regulate both toxicity and therapeutic efficacy, demonstrating that the historical trajectory of a medicine is shaped not only by its pharmacological properties but also by broader transformations in medical knowledge, technical expertise, and institutional frameworks.
PMID:
42823812
Bibliographic data and abstract were imported from PubMed on 02 Oct 2026.
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