Extreme fasting among Daoist priestesses of the Tang Dynasty: an old Chinese variant of anorexia nervosa?

Daoism and the Tang Dynasty Shangqing School

Laozi (sixth century bce) was the legendary founder of the Dao School of philosophical thought and the author of Laozi, later renamed Daodejing (Classic of The Way and of Virtue). The main focus of Laozi was the seeking of the Dao, defined as an eternal, mystic, inexhaustible, all-embracing force or way that was also the progenitor of the universe. It advocated a practice called ‘Embracing the One’, a breathing technique for retaining qi (qi is air, which is believed to contain the cosmic Dao) within one’s body – akin to the soft breathing of an infant – and the adoption of an ascetic lifestyle free from desires and self-gratification through the comforts of life. Laozi also advocated ‘nonactivity’ (wuwei), which meant non-involvement in the mundane things of life (success, fame, wealth, power) and nurturing an unaffectedness towards its vicissitudes. In the third century BCE, Zhuangzi developed Laozi’s themes into much greater philosophical profundity and mysticism. It prescribed a breathing method called ‘tu na’ (exhaling forcefully and sucking in air) to maximize the absorption of qi, as well as several meditation techniques such as ‘Keeping the One’ (shouyi) and ‘Sitting in Oblivion’ (zuowang) to merge with the Dao.

During the second century ce, Daoism developed from a philosophy to a religion, and two major Daoist movements emerged: the Celestial Master and the Great Peace Schools. The Tang emperors made Daoism the state religion, and elevated it to be on par with Buddhism and Confucianism as the nation’s three major religions. During High Tang, the Shangqing School became the dominant movement within Daoism (Qing and Tang, 2006). Shangqing concepts such as qingju (‘lightness of feet’ = levitation) were enthusiastically embraced by most of the Tang emperors and a majority of the aristocratic scholar-official gentry families of the Tang imperial court (Li, 1989).

Body immortality in Shangqing Daoism

The Founder of Shangqing Daoism was a ‘Perfected Female Immortal’ (nuzhen) named Wei Huacun (252–334), who in her lifetime was a follower and minor official of the Celestial Master School. Wei was the leading deity who transmitted the 31 sacred ‘Shangqing texts’ to Yang Xi (330–386?), an erstwhile Celestial Master follower. Yang claimed that, from 364 to 370, he had a series of nocturnal visions of Wei, who appeared to him with a company of her fellow celestial cohorts, clad in heavenly-hued official cap and gown of the celestial Shangqing officialdom. Yang dutifully recorded this ‘revealed’ corpus, which contained the teachings for merging with the Dao by attaining body immortality. Yang also coined the name Shangqing, which meant supreme or upper clarity, for an intermediate stratum of heavens where the celestial Shangqing imperial officialdom was located, and where the Shangqing Perfected Male (zhen) and Female (nu-zhen) resided after they had attained perfect immortality status (Penny, 2000). The movement grew, but it also engendered apocryphal texts and forgeries of Yang’s manuscripts, so the need for a canon of Shangqing teachings became imperative. This task fell on the fourth Shangqing Patriarch, Tao Hongjing (456–536), an aristocrat and imperial court official. Tao retreated to Mount Mao (by then a Shangqing mecca) to edit and annotate Yang’s manuscripts, and he produced two key Shangqing compilations: Zhengao (Declarations of the Perfected, dated 499) and Dengzhen Yinjue (Secret Instructions on Ascension to Become a Perfected, dated 514). Throughout the entire Tang era, these compilations were accorded first place in the entire Daoist canon (Bokemkamp, 1997).

The idea of body immortality dated back to ancient China’s cult of immortals (xian) in the fourth century bce in Qi state (present-day Shandong). By the second century bce, the seeking of immortality and Dao became inextricably entwined, and Dao seekers were known as immortality seekers: ‘attaining Dao’ became interchangeable with ‘attaining immortality’ (Eskildsen, 1998). Shangqing doctrine equated attaining Dao with attaining body immortality. There were four main Shangqing doctrines:

Shangqing fasting, qi-breathing, and other austere practices

Fasting has had a long history in the Chinese culture; the earliest records of austere fasting dated back to China’s period of Antiquity (c. 2100–1028 bce) (Giles, 2008). Laozi promoted the idea that bland unseasoned foods were the best diet for a wuwei Dao-seeker. Zhuangzi emphasized the importance of combining the practice of austere fasting with qi ingestion. Dao seekers during Former Han (206 bce to 8 ce) added the use of medicaments and alchemicals to this regimen (Eskildsen, 1998; Xiao, 2005).

Even when not engaging in fasting and qi-swallowing, a Shangqing faithful would minimize her daily food intake by adhering to a diet of vegetables, while avoiding heavily seasoned food (an original concept of Laozi) and raw or preserved foods, as well as foods such as birds (considered ‘sons of heaven’), calendar animals (rabbit, cow, pig, chicken, lamb, snake), animal blood, and the five domestic animals (horse, cow, lamb, pig, dog) (YJQQ ² Book 19). Grains were avoided in the belief that they would generate excrements that defiled the body and shortened life.

In preparation for austere fasting, the adept would take evergreen plants (pine sapling, pine resin, fungi) in the belief that they would confer longevity, and herbal plants such as sesame and tuckahoe (fuling) (Li, 1962). During austere fasting, the adept would drink only one to three pints (sheng) of water a day. To mitigate thirst, she swallowed her own saliva (‘jade fluid’) which she might increase by frequently rolling her tongue around the oral cavity (Xiao, 2005), or by sucking on a jujube seed (YJQQ Book 59). Once the qi-swallowing exercises started, the adept would strive to stop eating completely (bu shi) (Xiao, 2005). However, for prolonged regimens she could rely on a meagre diet of herbal-medical foods foraged from forests and hills, such as Atracrylodes ovata (zhu), sesame, calamus, tuckahoe, mushrooms and lotus. Nine jujubes and nine one-inch square Atractylis root cakes were also frequently ingested (‘nine’ being homonymous with long-lasting) (YJQQ Book 59).

Pebbles of quartz, jade, mica, lodestone and stalactites (‘stone breasts’) were ingested during extended periods of fasting to reduce hunger, and in the belief that they would confer permanence to a corruptible body. The most valued rock recipe was five white, perfectly round quartz pebbles pre-soaked in a special sauce, taken to preserve the vitality of the five viscera (heart, liver, pancreas, lung and kidney), so that they could survive the process of corpse liberation and become a part of the immortal body (Xiao, 2005). Laxatives were used to force out the pebbles when fasting ended.

In addition to swallowing rocks, adepts also used medicaments and alchemicals in the belief that they would make their body incorruptible and enable them to attain immortality (Akahori, 1989; Zhang, 2004). Medicaments were made from minerals such as realgar and plants such as fuling, fir/cedar cone, sesame, and Atractylis root. Alchemicals, called jindan (gold drug) or jinsha (gold dust) by Shangqing followers, consisted mainly of mercuric sulfide (cinnabar) but also other metals such as gold. Fasting Daogu apparently more often used medicaments than alchemicals (Huang, 2006), presumably because of the latter’s prohibitively high cost. The disastrous effects of alchemical use probably contributed to Shangqing’s eventual demise, as we will briefly discuss later.

For qi-swallowing, the adept took a gulp of air by mouth and swallowed it into the stomach in the belief that this swallowed qi would nourish and hence cosmicize her body. The ultimate goal of qi-swallowing was to attain ‘foetal breathing’ (taixi), which required the adept to hold a mouthful of air for a period of 120 heartbeats (Xiao, 2005) before swallowing it to allow for its maximal absorption.

The usual duration of each fasting-cum-qi-swallowing regimen was three years, although some texts mandated longer periods. At the completion of a regimen, the adept could resume a regular diet and alternative cycles of fasting and regular eating could be repeated ad infinitum. However, in their zealous quest for body immortality, many Shangqing adepts chose to fast continuously for 20 or more years. ‘To stop eating food is the way to life. To ingest Qi is to obtain Dao itself’ (YJQQ Book 59).

By Middle Tang, the mainline Shangqing doctrine of body immortality through extreme fasting and other austere practices was losing its appeal and coming under increasing pressure for revision. Foremost among the revisionists was Shangqing’s twelfth lineage Patriarch, Sima Chengzhen (647–735), who proposed a doctrine of spirit (as opposed to body) immortality (Kohn 1993; Qing 1985). The disastrous effect of alchemical use probably also damaged Shangqing’s popularity: at least six Middle and Late Tang emperors died from cinnabar poisoning, as did many of the elite gentry (Official Tang History, Former Edition, 1999). However, sociopolitical upheavals most probably caused the eventual demise of Shangqing (Official Tang History, Former Edition, 1999). The An Lushan (755–763) and Wang Cao (875–884) rebellions weakened imperial court support as the Tang emperors lost power, and many court officials perished. The years of ravage during these rebellions made it impossible for the elite to continue a quest for body immortality; with the widespread destruction of Shangqing belvederes and the deaths of their resident Daoshi and Daogu, enthusiasm for Shangqing waned. By Late Tang, Shangqing was disapppearing from Chinese history, although Sima Chengzhen’s doctrine of spirit immortality was later adopted by Neo-Confucianists and Zen Buddhists in the Song dynasty. With the demise of Shangqing, extreme fasting among Daoist followers also ceased.

An old Chinese variant of anorexia nervosa?

A cultural emphasis on thinness is often assumed to play an important role in the pathogenesis of an eating disorder (Hsu, 1997), but this ‘acculturation’ view has been repeatedly challenged. Rieger et al. (2001) argued that weight concerns and emphasis on thinness are not specific to western cultures, and non-western values and beliefs may also contribute to the pathogenesis of anorexia nervosa among women in these eastern cultures. Lee and Katzman (2002) and Humphry and Ricciardelli (2004) have proposed an alternative ‘culture clash’ view to explain the apparent increase of eating disorders in non-western cultures coming under the increasing influence of western beliefs and values. They emphasize the pathogenetic role of disconnection, transition and oppression of young women caught between the demands of two conflicting cultures. Even the concept of weight or fat phobia as a core diagnostic element of anorexia nervosa has been questioned for being western ethno-centric (Franko, 2007; Keel and Klump, 2003). In the context of this discussion, we might consider whether the fasting of the Tang Daogu can be seen as an old variant of modern-day anorexia nervosa.

In a similar vein, Bell (1987) has made comparisons between modern anorexic patients and medieval fasting saints such as Catherine of Siena, calling the latter ‘holy anorexics,’ a description which expresses both the religious and pathological dimension. Others have echoed this view (e.g. Banks, 1996; Keel and Klump, 2003). Bynum (1987), on the contrary, categorically rejects any equivalence between present-day anorexia nervosa and ascetic medieval European fasting, and emphasizes the cultural-symbolic significance of female mysticism in medieval European Christian fasting. In Bynum’s feminist-inspired interpretation, through their fasting practices these medieval Christian women not only sought a direct encounter with God but also acquired a place of their own within the patriarchal Church. As such, they were able to shape their lives in a constructive, meaningful and acceptable way. Others less inspired by feminist views have also argued against the conflation of religious fasting and anorexia nervosa (e.g. Habermas, 2005; Vandereycken and van Deth, 1994).

Tang Shangqing self-starvation and medieval Christian fasting thus share similar cultural-symbolic significance and spiritual and personal meaning, but differed on several counts. First, unlike the medieval female European saint who fasted to mortify her carnal flesh ‘for perfection in the eyes of her God’ (Brumberg, 1988), the Shangqing Daogu fasted so that her body could be refined by cosmic qi and hence attain the highest immortality status of a Perfected Being, attired with the regalia of heavenly-hued cap and gown of the celestial Shangqing officialdom, and thus be fit for residence in the Shangqing paradisiacal kingdom. Second, unlike medieval European austere fasting practised predominantly by female saints, Tang Shangqing fasting was practised by both male and female adepts for the same purpose. Finally, while European Christian fasting was characterized by self-starvation and religious meditation, Tang fasting was practised in conjunction with mental visualization, medicament use, qi and stone swallowing, and corpse liberation.

While we take the view that the Tang Daogu fasted to attain spiritual fulfilment and acquire a place of their own within the patriarchal Shangqing system, we consider it fallacious to equate their fasting with an eating disorder. First, it seems to us unwise to label and characterize a widespread lifestyle as a psychiatric disorder. Shangqing fasting was a popular practice in pursuit of a mystical state of existence among ardent believers who lived in a different time, place and culture, and we are not justified in medicalizing and pathologizing it as a disorder. If we do so, we run the risk of committing a ‘category fallacy’ (Kleinman, 1988). Second, our reading of the historical documents has not convinced us that the fasting Shangqing faithfuls refused to maintain a normal bodyweight. In fact, ample evidence indicated that the Tang Daogu did not fast to achieve a thin body. For them, body immortality was not achieved through a thin body per se, but through the attainment of a qi-cosmicized body devoid of worldly food and defiling excrement. Finally, although other schools of Daoism have persisted in Chinese society even to this day, the demise of Shangqing in Late Tang brought a halt to the practice of extreme fasting and other austere practices such as corpse liberation, proving our point that the extreme fasting among Shangqing Daogu was directly related to their peculiar beliefs rather than some fascination with body thinness. In this connection, we note that opposition of the Roman Catholic Church to protracted fasting as the ideal of female piety probably finally halted medieval religious fasting in Europe (Vandereycken and van Deth, 1994). Could we conceptualize Tang fasting in terms of a striving for control, say, in the face of a culture clash or in response to the patriarchal social structures in which Tang women were trapped (Humphry and Ricciardelli, 2004)? Control was indeed necessary for the austere and prolonged fasting, but the ultimate purpose of Shangqing, for female as well as male faithfuls, was a quest for body immortality and residence in the paradisiacal kingdom, not personal control as such.

In conclusion, equating any ancient form of extreme religious fasting with present-day anorexia nervosa is to minimize basic differences in the symbolic meaning and significance and in the sociocultural context of the two fasting experiences, as well as to ignore the incompatibility of the two world-views behind the experiences: one that gave spiritual or religious meaning and the other derived from scientific psycho-biological-social explanations of life experiences (Vandereycken and van Deth, 1994). Since it was a change in world-views that halted both the Tang fasting and the medieval European fasting, we are left wondering what changes are required in our secular world-view to halt the current fasting in eating disorders.