Illness Narratives in a Fourth-Century Chinese Correspondence

Antje Richter explores the illness narratives in the informal correspondences of Wang Xizhi, the most celebrated of Chinese calligraphers. This essay is adapted from her journal article “The Trouble with Wang Xizhi, Illness and Healing in a Fourth-Century Chinese Correspondence”, co-written with Charles Chace and originally published in T’oung Pao. 

The surviving letters of the great calligrapher Wang Xizhi 王羲之 (303–361) are the earliest sizeable corpus of personal health reports in Chinese literature. Wang’s letters not only allow us glimpses into informal letter writing practices of the period. Because health, or rather the lack thereof, is such a pervasive topic in these letters, they are also a valuable source for the study of Chinese medical history (Richter and Chace 2017).


Letter writing and calligraphy

Plenty of casual letters similar to those of Wang Xizhi must have been written in early medieval China, but they are lost forever. Regarded as too quotidian in content and lacking in literary merit, they fell out of historical transmission (Richter 2011). What was so special about Wang Xizhi’s letters then? The fourth century was the time in China when calligraphy became the most elevated visual art form, and it was Wang Xizhi who became the epitome of this new appreciation. As a result, more than six-hundred of Wang’s letters were transmitted. Although there are no original manuscripts left, we still have reproductions of various kinds (copies, inscriptions, or rubbings) or the letter texts as they were printed in catalogues of calligraphic works and other historical sources (Ledderose 1979, Richter 2014).

Wang Xizhi’s Complaints

That Wang Xizhi brings up illness in his letters is only to be expected, since health reports, inquiries, and wishes are a regular component of epistolary practice across cultures. It is also typical that the health of others—the correspondents and their families, mutual friends and acquaintances, and members of Wang’s family—is a more prevalent subject than the writer’s health. What is extraordinary, however, is how frequently and in how much detail Wang Xizhi comments on his own maladies. There is only one note in which he declares to be “in excellent health” (ti qi ji jia 體氣極佳) and just a dozen more in which he describes himself as being “in fairly good health” (pingping 平平) or “fairly well” (ke er 可耳). In about three dozen letters, he briefly states that he is “not quite well” (xiao jia 小佳), “unwell” (bu ping 不平), etc., without going into details. Approximately eighty letters mention various indispositions, sometimes along with accounts of the distress they caused or details of their treatment. Wang appears to have been willing to write about his ailments in considerable detail with a wide range of correspondents. Given how few letters from the period survive, it is difficult to tell if this was just an idiosyncrasy on Wang’s part. It seems more likely, though, that writing about illness was a wider practice in letter writing.

Judging from the many complaints he mentions—including chronic or at least recurring complaints as well as acute ailments and aches, often related to the seasons—Wang Xizhi emerges as someone who considered himself to be sickly and whose health was probably indeed infirm. A reader of his letters is left with the impression that Wang, at certain points in his life, felt he was wasting away and that he was deeply distressed about this. We know that he retired from government office pleading illness, and it is regrettable that the petition he must have produced on this occasion has not survived. It would be fascinating to compare Wang Xizhi’s references to his physical body in that lost document with the accounts he gives in his personal letters.

Fatigue and Weakness

Among the most pervasive of Wang’s complaints are fatigue and weakness. In about sixty letters, he describes himself as “still very weak” (shen shang lie 甚尚劣), “tired and weak” (dun lie 頓劣), or “frail and worn out” (lei fa 羸乏), to mention only three of the phrases he uses. The following notes (Quan Jin wen 全晉文) are representative of this complaint; they are quoted in full to show how the health report is embedded into a letter’s overall message:

On the 1st day of the 1st month Xizhi reports:

Suddenly we have moved into a new year. I am overwhelmed by feelings of longing for you that I can hardly endure. What can I do? What can I do? How have you been with all your illnesses in this unusual cold? I have not had any news from you for many days and miss you more than I can say. I am just a little better and still very weak. Despite all my efforts, my dispatch cannot inform you comprehensively. This is what Xizhi reports.
初月一日羲之報。忽然改年。感思兼傷。不能自勝。奈何奈何。異更寒。諸疾 比復何似。不得問多日。懸心不可言。吾猶小差。甚尚劣。力遣不知。羲之 報。

Having received your announcement [i.e., letter], I know that Changping is not well. It would be excellent if he got better soon. I hope everything is going well for you, sir. Knowing about your ailments, I am concerned about you. I am thinking of you with a weary heart. I myself eat very little. I am weary and very tired. My reply is not comprehensive.
Wang Xizhi bows repeatedly.
得告。承長平未佳。善得適適。君如常也。知有患者。耿耿。念勞心。食少。 勞甚頓。還白不具。王羲之再拜。

As personal pronouns and style show, Wang wrote such letters to equals and superiors alike. His inquiries about the physical well-being of his correspondents show his intimate knowledge of the other’s disposition and their close relationship. The correspondents seem to be in frequent contact, otherwise it would not just be “many days” that went by without a letter. That the health inquiries appear rather unspecific could be due to common politeness: unless there was an acute situation that required attention, it might not have been considered tactful to write about the recipient’s ailments in too much detail. The second letter shows Wang writing not only about his own health and that of his correspondent, but also exchanging news about the health of mutual acquaintances. This and many other messages that relate rumors about other people hint at the social networks in which these letters circulated and which they helped to maintain.

Gastrointestinal Complaints

Gastrointestinal problems are the most common specific complaint in Wang Xizhi’s letters. Wang reports that he is troubled with diarrhea, has no desire for food, is not digesting what he eats, is suffering from belly aches, dry heaves, and vomiting. In the following letter, obviously addressed to a superior, Wang Xizhi mentions a whole spectrum of digestive complaints:

On the 12th day of the 1st month Xizhi writes again:

Having received your letter of the 26th of last month, I feel comforted. Have you been fairly well lately? Your servant’s diarrhea is persistent and won’t stop. I have not the slightest appetite. And if I eat something, it is never digested. All my maladies are so bad. I do not know how to get any relief. I am at a loss for words. I cannot go into details.
This is what Xizhi lets you know.
初月十二日。羲之累書。至得去月二十六日書。為慰。比可不。僕下連連不 斷。無所一欲。噉輒不化消。諸弊甚。不知何以救之。罔極然。及不一一。羲 之白。

In the next letter, Wang’s health report is presented in a narrative covering a night and a morning. This contributes to the impression that he and his correspondent wrote each other frequently, perhaps daily, similar to text messaging today:

This morning it was extremely cold. Having received your letter, I know that your wife has a slight cough again and does not get much sleep but tosses and turns ever more. I hope she will soon be better. What medicine has she been given? Thinking of you, I am deeply worried. Are you fairly well? I vomited heavily again last night. When I ate a little something, it happened again. Only in the morning did I begin to feel fairly well. I gratefully acknowledge your affection.
Wang Xizhi knocks his head on the ground.
旦極寒。得示。承夫人復小欬。不善得眠。助反側。想小爾。復進何藥。念足 下猶悚息。卿可否。吾昨暮復大吐。小噉物便爾。旦來可耳。 知足下念。王羲之頓首。

Unassuming as it may appear, this letter demonstrates how complex epistolary communication about illness can be. It includes health inquiries and reports referring to three different people and presents a mix of rhetorical motivations that ultimately affirm the bond between the correspondents: expressing sympathy and, tacitly, seeking it; asking for and providing medical information; signaling competency in treatment and offering help; venting distress. Wang’s concern for the correspondent’s wife is particularly interesting. Asking about her condition and medication, he presents himself not only as deeply caring but also as competent to judge the wife’s treatment and perhaps to make alternative suggestions or to help in procuring drugs. This is a topic that occurs in other letters, for instance, in the “Letter about Sandalwood and Walnuts” (“Zhan ji hu tao tie” 旃罽胡桃帖) (Richter and Chace 2017, 88–89).

Wang Xizhi’s “Letter about Sandalwood and Walnuts”. 13th-century rubbing of the letter in the album “On the Seventeenth Day”. The Metropolitan Museum of Art, New York.
Copy of Wang Xizhi’s “Letter about Sandalwood and Walnuts” (“Zhan ji hu tao tie” 旃罽胡桃帖)
Partial copy of Wang’s “Letter about Sandalwood and Walnuts”. Calligraphy practice preserved among the Dunhuang manuscripts, 10th century (?). Source / Bibliothèque nationale de France.

Illness and Personal Correspondence

Wang Xizhi’s letters, as first-person reports of a patient and educated layman, provide us with glimpses of illness and healing from the perspective of conversations between relatives, friends, and acquaintances. While the correspondents may also have been concerned with an exchange of practical information about treatment, the most important function of these health reports and inquiries was to share information about afflictions and worries and to extend sympathy. This last motive seems to have been an important aspect of intimate communication, serving the wish to maintain relationships as well as the desire better to cope with illness, aging, and mortality.

It is tempting to speculate about the role physical suffering may have played for Wang Xizhi’s calligraphic art: did he achieve mastery despite persistent ill health or did his genius depend on it, at least in part? Were some of the most admired features of Wang Xizhi’s handwriting—such as the “sudden changes of speed and brush direction” that Robert Harrist has observed (1999, 5)—owing to his suffering, perhaps even a particular condition? Similar questions have been fruitfully pursued in Chinese art history of the early modern period and in Western art-historical scholarship, where the well-documented biographies of certain painters allow the reconstruction of their medical histories. Even if we cannot speak with the same certainty about the earlier and more elusive Wang Xizhi, it is worthwhile posing these questions. By allowing us to get closer to the calligrapher’s body, the illness narratives Wang left behind help us not only to expand our understanding of fourth-century medical and epistolary practices, but also to heighten our awareness of the circumstances that shape the artistic process.



Harrist, Robert E., Jr. 1999. “Reading Chinese Calligraphy” in The Embodied Image: Chinese Calligraphy from the John B. Elliott Collection. Princeton University Art Museum.

Ledderose, Lothar. 1979. Mi Fu and the Classical Tradition in Chinese Calligraphy. Princeton University Press.

Quan Jin wen 全晉文 [Complete Prose of the Jin Dynasty], in Quan shanggu Sandai Qin Han Sanguo Liuchao wen 全上古三代秦漢三國六朝文 [Complete Prose of the Three Dynasties of High Antiquity, of the Qin, Han, Three Kingdoms and Six Dynasties Periods], edited by Yan Kejun 嚴可均 (1762-1843); rpt. Beijing: Zhonghua shuju, 1958.

Richter, Antje. 2011. “Beyond Calligraphy: Reading Wang Xizhi’s Letters.” T’oung Pao 96: 370–407.

Richter, Antje. 2014. “Wang Xizhi” in The Berkshire Dictionary of Chinese Biography. Berkshire Publishing. (online at

Richter, Antje, and Charles Chace. 2017. “The Trouble with Wang Xizhi: Illness and Healing in a Fourth-Century Chinese Correspondence.” T’oung Pao 103: 33–93.

About the author

Antje Richter is Associate Professor in the Department of Asian Languages and Civilizations at the University of Colorado Boulder. She has written on early Chinese notions of sleep, on medieval letter-writing, illness narratives, and literary thought. Currently she is completing a monograph on notions of health and illness in medieval Chinese literature.

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