Dunhuang: A Millennia-Long Silk Road Hub of Traditional Chinese Medicine

Dunhuang, located in the northwest of Gansu Province, has long been a crucial town on the Silk Road and a hub for cultural exchanges between the East and the West. The Dunhuang murals, treasures of Mogao Grottoes art, not only showcase the grandeur of Buddhist culture but also document various aspects of ancient society, including the presence of traditional Chinese medicine (TCM). As an integral part of Chinese civilization, TCM, with its unique theoretical system and practical methods, spread along the Silk Road, engaging with and integrating into the medical traditions of the Western Regions and beyond. This article explores traces of TCM in the Dunhuang murals and examines its millennia-long transmission and evolution along the Silk Road.

I. Medical Imagery in the Dunhuang Murals

The Dunhuang murals are renowned for their delicate brushwork and diverse themes, many of which depict medical scenes. In Mogao Cave 205 and Cave 220, for instance, murals portray the Medicine Buddha (Bhaisajyaguru) holding medicinal tools, surrounded by patients or devotees. These images, beyond their religious significance, reflect contemporary concerns about disease and medical treatment. A mural in Cave 257 even depicts a figure holding an acupuncture needle, seemingly performing acupuncture on a patient—an illustration that resonates with the acupuncture techniques recorded in the Huangdi Neijing (Yellow Emperor’s Inner Canon).

Additionally, many elements related to traditional Chinese medicine appear in the murals. Some donor portraits feature offerings that include herbs and medicinal pills, suggesting the importance of herbal medicine in daily life. The Dunhuang manuscripts, which preserve fragments of medical texts such as Newly Revised Materia Medica (Xin Xiu Ben Cao) and Essential Prescriptions for Every Emergency (Qian Jin Fang), further corroborate the murals' depictions, confirming that these medical images were deeply connected to real medical practices. Together, these murals and documents paint a vivid picture of the flourishing development of TCM in the eastern segment of the Silk Road.

II. The Dissemination of TCM Along the Silk Road

The Silk Road was not only a trade route but also a conduit for cultural and intellectual exchange. Traditional Chinese medicine traveled westward along with merchants, monks, and diplomats, with Dunhuang serving as a key witness and transit hub for this exchange.

By the Han and Tang dynasties, TCM had already established a systematic theoretical framework, including Yin-Yang theory, the Five Elements, meridian doctrines, and visceral organ theories. These medical concepts spread westward through the Silk Road and interacted with local medical traditions such as Greek-Arabic (Unani) and Indian Ayurvedic medicine. For instance, certain medicinal materials mentioned in Essential Prescriptions for Every Emergency by Sun Simiao, such as black pepper and myrrh, clearly originated from the Western Regions, indicating how Silk Road trade facilitated the exchange of medicinal substances. Some murals in Dunhuang even depict foreign figures holding medicine pouches or medical tools, suggesting the presence of foreign medical practitioners in China.

Meanwhile, TCM also absorbed elements of foreign medical practices. Ingredients such as fragrant spices and mineral-based medicines from the Western Regions gradually found their place in Chinese prescriptions. Some medical recipes in the Dunhuang manuscripts, such as the use of frankincense (introduced from Persia) for treating injuries, highlight TCM’s openness to external influences. This bidirectional exchange enriched TCM practices and helped sustain their vitality along the Silk Road.

III. The Evolution of TCM Along the Silk Road

Over time, the dissemination and development of TCM along the Silk Road underwent several transformations. The Tang dynasty marked the peak of TCM’s prosperity, as evidenced by the Dunhuang murals and manuscripts. During the Song and Yuan dynasties, as the Mongol Empire expanded, TCM reached deeper into Central and Western Asia, engaging more profoundly with Arabic medicine. Prominent Arabic physicians such as Al-Razi and Avicenna referenced Chinese treatments and medicinal herbs in their works, underscoring the medical exchange fostered by the Silk Road.

By the Ming and Qing dynasties, maritime trade routes gradually overshadowed the overland Silk Road, shifting the focus of TCM dissemination toward Southeast Asia. However, Dunhuang, as a historical witness, preserved invaluable records of early medical exchanges. In modern times, renewed exploration of Dunhuang culture has unveiled a wealth of medical manuscripts, including acupuncture diagrams and herbal prescriptions, providing key insights into the global development of TCM.

IV. TCM and Dunhuang in the Contemporary Perspective

Today, as part of UNESCO’s Intangible Cultural Heritage, TCM continues to gain global recognition. The Dunhuang murals and manuscripts offer a precious lens through which we can trace its historical trajectory. Through digital restoration of murals and systematic research on ancient manuscripts, modern scholars have been able to reconstruct ancient medical practices. Some prescriptions found in the Dunhuang medical texts have even been validated by contemporary pharmacology, confirming their clinical efficacy. This not only underscores the scientific foundation of TCM but also inspires new possibilities for integrating traditional medicine with modern technology in a globalized world.

When Dunhuang murals meet TCM, we witness not just an intersection of art and medicine but also a microcosm of cultural exchanges along the Silk Road. From the fine tips of acupuncture needles to the aromatic scents of medicinal herbs, from China to the Western Regions, TCM has continually evolved by assimilating diverse influences, ultimately becoming a precious gem in the history of medicine. As historical canvases, the Dunhuang murals not only document this journey but also provide infinite inspiration for the future. Perhaps the fusion of TCM and Dunhuang’s heritage will continue to shine, writing new chapters in the legend of Silk Road medicine.